Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.14 / $104.14 / $104.14	Facility	26	$104.14	$104.14	$104.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $409.66 / $561.34	Professional		$342.85	$409.66	$561.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $104.14 / $140.00	Professional	26	$85.00	$104.14	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.73 / $305.52 / $425.54	Professional	TC	$257.73	$305.52	$425.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $142.88 / $142.88 / $142.88	Professional	26	$142.88	$142.88	$142.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $379.81 / $379.81 / $379.81	Professional	50	$379.81	$379.81	$379.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.39 / $460.00 / $781.51	Professional		$307.39	$460.00	$781.51
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.81 / $140.00 / $249.02	Professional	26	$79.81	$140.00	$249.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $227.57 / $320.00 / $511.50	Professional	TC	$227.57	$320.00	$511.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $395.43 / $559.44 / $925.00	Professional		$395.43	$559.44	$925.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.44 / $120.00 / $219.20	Professional	26	$83.44	$120.00	$219.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $300.77 / $449.36 / $730.53	Professional	TC	$300.77	$449.36	$730.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $131.54 / $153.00 / $264.38	Facility	26	$131.54	$153.00	$264.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,261.69 / $1,261.69 / $1,261.69	Professional		$1,261.69	$1,261.69	$1,261.69
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $1,892.53 / $1,892.53 / $1,892.53	Professional	50	$1,892.53	$1,892.53	$1,892.53
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $948.45 / $948.45 / $948.45	Professional	TC	$948.45	$948.45	$948.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.45 / $300.43 / $463.28	Professional		$108.45	$300.43	$463.28
United Facility/Professional Professional Modifier Low / Median / High Price $368.24 / $510.45 / $919.28	Professional		$368.24	$510.45	$919.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.75 / $105.84 / $170.62	Professional	26	$82.75	$105.84	$170.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $277.81 / $412.31 / $699.98	Professional	TC	$277.81	$412.31	$699.98