Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.34 / $83.00 / $133.88	Facility	26	$77.34	$83.00	$133.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.92 / $275.00 / $438.99	Professional		$112.92	$275.00	$438.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $70.14 / $103.18	Professional	26	$50.07	$70.14	$103.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.52 / $217.64 / $368.85	Professional	TC	$116.52	$217.64	$368.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.78 / $164.24 / $164.24	Professional		$152.78	$164.24	$164.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.00 / $58.94 / $91.74	Professional	26	$41.00	$58.94	$91.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $142.13 / $142.13 / $142.13	Professional	TC	$142.13	$142.13	$142.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.78 / $340.00 / $579.62	Professional		$152.78	$340.00	$579.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.25 / $76.88 / $152.11	Professional	26	$51.25	$76.88	$152.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.53 / $264.00 / $420.86	Professional	TC	$101.53	$264.00	$420.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $291.02 / $525.00	Professional		$208.93	$291.02	$525.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.34 / $76.98 / $141.47	Professional	26	$53.34	$76.98	$141.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $143.30 / $235.70 / $385.69	Professional	TC	$143.30	$235.70	$385.69
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $83.78 / $97.00 / $172.98	Facility	26	$83.78	$97.00	$172.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $621.99	Professional		$145.72	$145.72	$621.99
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $202.58 / $202.58 / $202.58	Professional	26	$202.58	$202.58	$202.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $127.90 / $207.66	Professional		$44.14	$127.90	$207.66
United Facility/Professional Professional Modifier Low / Median / High Price $181.68 / $255.70 / $448.66	Professional		$181.68	$255.70	$448.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.45 / $76.40 / $118.39	Professional	26	$54.45	$76.40	$118.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.10 / $198.37 / $361.74	Professional	TC	$127.10	$198.37	$361.74