Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $83.00 / $103.75	Facility	26	$83.00	$83.00	$103.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.91 / $303.77 / $485.65	Professional		$229.91	$303.77	$485.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $71.48 / $146.96	Professional	26	$54.86	$71.48	$146.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.21 / $248.90 / $408.74	Professional	TC	$169.21	$248.90	$408.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $210.64 / $210.64 / $226.44	Professional		$210.64	$210.64	$226.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.00 / $60.47 / $100.69	Professional	26	$45.00	$60.47	$100.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $125.19 / $154.38 / $154.38	Professional	TC	$125.19	$154.38	$154.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $210.64 / $389.00 / $705.71	Professional		$210.64	$389.00	$705.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.25 / $113.00 / $189.42	Professional	26	$56.25	$113.00	$189.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.38 / $276.00 / $496.00	Professional	TC	$154.38	$276.00	$496.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.44 / $344.10 / $606.59	Professional		$239.44	$344.10	$606.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.68 / $84.00 / $155.19	Professional	26	$58.68	$84.00	$155.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.69 / $266.29 / $450.16	Professional	TC	$174.69	$266.29	$450.16
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $91.56 / $135.00 / $197.00	Facility	26	$91.56	$135.00	$197.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $846.07	Professional		$145.72	$145.72	$846.07
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $223.41 / $223.41 / $223.41	Professional	26	$223.41	$223.41	$223.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $199.33 / $304.88	Professional		$44.14	$199.33	$304.88
United Facility/Professional Professional Modifier Low / Median / High Price $231.37 / $343.10 / $563.33	Professional		$231.37	$343.10	$563.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.70 / $78.63 / $143.71	Professional	26	$57.70	$78.63	$143.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.47 / $253.69 / $430.47	Professional	TC	$168.47	$253.69	$430.47