Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.26 / $78.27 / $97.05	Facility	26	$78.26	$78.27	$97.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.43 / $459.85 / $1,121.15	Professional		$229.43	$459.85	$1,121.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.12 / $111.15 / $374.32	Professional	26	$64.12	$111.15	$374.32
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $131.50 / $131.50 / $131.50	Professional	50	$131.50	$131.50	$131.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $195.63 / $335.00 / $472.35	Professional	TC	$195.63	$335.00	$472.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.45 / $203.48 / $218.74	Professional		$167.45	$203.48	$218.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.71 / $59.72 / $90.03	Professional	26	$47.71	$59.72	$90.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $201.26 / $201.26 / $218.73	Professional	TC	$201.26	$201.26	$218.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.50 / $460.00 / $662.58	Professional		$204.50	$460.00	$662.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.72 / $64.68 / $100.15	Professional	26	$59.72	$64.68	$100.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.76 / $400.00 / $539.55	Professional	TC	$143.76	$400.00	$539.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.31 / $493.49 / $844.13	Professional		$263.31	$493.49	$844.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $85.93 / $164.75	Professional	26	$61.68	$85.93	$164.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.95 / $405.17 / $721.80	Professional	TC	$192.95	$405.17	$721.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $97.46 / $113.00 / $198.06	Facility	26	$97.46	$113.00	$198.06
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $844.30	Professional		$187.72	$187.72	$844.30
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $235.96 / $235.96 / $235.96	Professional	26	$235.96	$235.96	$235.96
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $281.58 / $281.58 / $1,266.45	Professional	50	$281.58	$281.58	$1,266.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $183.60 / $274.57	Professional		$44.14	$183.60	$274.57
United Facility/Professional Professional Modifier Low / Median / High Price $241.03 / $408.38 / $752.22	Professional		$241.03	$408.38	$752.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.23 / $82.72 / $137.83	Professional	26	$61.23	$82.72	$137.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.66 / $293.95 / $651.51	Professional	TC	$179.66	$293.95	$651.51