Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.45 / $83.00 / $103.75	Facility	26	$70.45	$83.00	$103.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.25 / $232.74 / $357.50	Professional		$45.25	$232.74	$357.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $61.45 / $283.43	Professional	26	$43.82	$61.45	$283.43
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $767.60 / $767.60 / $767.60	Professional	50	$767.60	$767.60	$767.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.46 / $192.00 / $291.63	Professional	TC	$83.46	$192.00	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.00 / $119.31 / $128.26	Professional		$98.00	$119.31	$128.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $46.72 / $78.83	Professional	26	$35.19	$46.72	$78.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.93 / $105.39 / $114.54	Professional	TC	$80.93	$105.39	$114.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.31 / $294.00 / $496.24	Professional		$119.31	$294.00	$496.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.04 / $103.00 / $148.75	Professional	26	$44.04	$103.00	$148.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.28 / $191.00 / $335.84	Professional	TC	$75.28	$191.00	$335.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.28 / $241.98 / $421.95	Professional		$167.28	$241.98	$421.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.03 / $67.50 / $116.38	Professional	26	$50.03	$67.50	$116.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.55 / $188.54 / $322.82	Professional	TC	$110.55	$188.54	$322.82
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $77.84 / $92.00 / $147.12	Facility	26	$77.84	$92.00	$147.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $482.23	Professional		$88.83	$88.83	$482.23
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $175.09 / $175.09 / $175.09	Professional	26	$175.09	$175.09	$175.09
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $133.25 / $133.25 / $723.34	Professional	50	$133.25	$133.25	$723.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $118.03 / $176.54	Professional		$44.14	$118.03	$176.54
United Facility/Professional Professional Modifier Low / Median / High Price $148.31 / $216.16 / $376.02	Professional		$148.31	$216.16	$376.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.13 / $63.37 / $112.75	Professional	26	$46.13	$63.37	$112.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.01 / $155.35 / $285.05	Professional	TC	$98.01	$155.35	$285.05