Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.23 / $83.00 / $84.01	Facility	26	$81.23	$83.00	$84.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.41 / $268.77 / $357.50	Professional		$141.41	$268.77	$357.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $60.32 / $115.70	Professional	26	$51.28	$60.32	$115.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.18 / $192.00 / $220.00	Professional	TC	$82.18	$192.00	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $135.15 / $135.15 / $135.15	Professional		$135.15	$135.15	$135.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.52 / $56.45 / $93.99	Professional	26	$42.52	$56.45	$93.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.49 / $102.49 / $102.49	Professional	TC	$102.49	$102.49	$102.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.72 / $331.00 / $507.19	Professional		$125.72	$331.00	$507.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.51 / $137.00 / $183.24	Professional	26	$52.51	$137.00	$183.24
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.20 / $194.00 / $343.69	Professional	TC	$73.20	$194.00	$343.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.50 / $253.39 / $438.59	Professional		$150.50	$253.39	$438.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $78.81 / $144.94	Professional	26	$54.82	$78.81	$144.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.67 / $185.64 / $318.00	Professional	TC	$89.67	$185.64	$318.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $85.85 / $115.00 / $198.00	Facility	26	$85.85	$115.00	$198.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $512.07	Professional		$88.83	$88.83	$512.07
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $209.65 / $209.65 / $209.65	Professional	26	$209.65	$209.65	$209.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $93.18 / $165.85	Professional		$44.14	$93.18	$165.85
United Facility/Professional Professional Modifier Low / Median / High Price $140.76 / $213.11 / $404.90	Professional		$140.76	$213.11	$404.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.89 / $73.19 / $134.18	Professional	26	$54.89	$73.19	$134.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.34 / $132.61 / $300.50	Professional	TC	$83.34	$132.61	$300.50