Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.65 / $78.66 / $97.53	Facility	26	$78.65	$78.66	$97.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.00 / $425.00 / $1,240.20	Professional		$153.00	$425.00	$1,240.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.04 / $118.59 / $435.75	Professional	26	$65.04	$118.59	$435.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $252.40 / $252.40 / $465.80	Professional	50	$252.40	$252.40	$465.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $103.14 / $123.69 / $212.50	Professional	52	$103.14	$123.69	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.71 / $335.00 / $458.92	Professional	TC	$168.71	$335.00	$458.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.27 / $186.32 / $200.29	Professional		$153.27	$186.32	$200.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.02 / $64.52 / $107.44	Professional	26	$48.02	$64.52	$107.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $279.48 / $279.48 / $279.48	Professional	50	$279.48	$279.48	$279.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.65 / $176.83 / $226.09	Professional	TC	$104.65	$176.83	$226.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.32 / $460.00 / $744.96	Professional		$186.32	$460.00	$744.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.02 / $140.00 / $214.52	Professional	26	$60.02	$140.00	$214.52
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $126.31 / $320.00 / $562.66	Professional	TC	$126.31	$320.00	$562.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.01 / $475.46 / $812.27	Professional		$230.01	$475.46	$812.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $84.35 / $150.22	Professional	26	$61.68	$84.35	$150.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.51 / $355.12 / $682.68	Professional	TC	$159.51	$355.12	$682.68
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $97.46 / $130.00 / $228.00	Facility	26	$97.46	$130.00	$228.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $759.07	Professional		$187.72	$187.72	$759.07
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $281.58 / $281.58 / $1,138.60	Professional	50	$281.58	$281.58	$1,138.60
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $519.73 / $519.73 / $519.73	Professional	TC	$519.73	$519.73	$519.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $140.61 / $242.81	Professional		$63.54	$140.61	$242.81
United Facility/Professional Professional Modifier Low / Median / High Price $218.93 / $362.54 / $736.68	Professional		$218.93	$362.54	$736.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.59 / $83.15 / $138.51	Professional	26	$61.59	$83.15	$138.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.75 / $213.71 / $634.97	Professional	TC	$147.75	$213.71	$634.97