Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.59 / $124.59 / $146.47	Facility	26	$124.59	$124.59	$146.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.00 / $802.05	Professional		$250.00	$475.00	$802.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $290.01	Professional	26	$85.00	$140.00	$290.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.85 / $335.00 / $462.42	Professional	TC	$245.85	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $253.67 / $308.29 / $331.41	Professional		$253.67	$308.29	$331.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.39 / $102.93 / $171.39	Professional	26	$76.39	$102.93	$171.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $228.48 / $228.48 / $297.56	Professional	TC	$228.48	$228.48	$297.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.29 / $630.60 / $1,028.02	Professional		$308.29	$630.60	$1,028.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.75 / $167.00 / $241.75	Professional	26	$95.75	$167.00	$241.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $212.54 / $449.60 / $797.72	Professional	TC	$212.54	$449.60	$797.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $399.44 / $813.80 / $1,410.21	Professional		$399.44	$813.80	$1,410.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.23 / $133.21 / $237.33	Professional	26	$98.23	$133.21	$237.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.33 / $609.86 / $1,199.00	Professional	TC	$281.33	$609.86	$1,199.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $155.10 / $180.00 / $314.38	Facility	26	$155.10	$180.00	$314.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,279.94	Professional		$300.42	$300.42	$1,279.94
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $904.73 / $904.73 / $904.73	Professional	TC	$904.73	$904.73	$904.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $243.45 / $407.48	Professional		$96.53	$243.45	$407.48
United Facility/Professional Professional Modifier Low / Median / High Price $376.45 / $590.66 / $1,290.40	Professional		$376.45	$590.66	$1,290.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.62 / $126.58 / $196.83	Professional	26	$97.62	$126.58	$196.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $260.02 / $442.78 / $1,023.81	Professional	TC	$260.02	$442.78	$1,023.81