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 $235.94 / $366.58 / $1,147.50	Professional		$235.94	$366.58	$1,147.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.06 / $78.70 / $160.97	Professional	26	$55.06	$78.70	$160.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $175.43 / $306.18 / $502.82	Professional	TC	$175.43	$306.18	$502.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.91 / $240.80 / $392.00	Professional		$194.91	$240.80	$392.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.91 / $66.26 / $110.34	Professional	26	$49.91	$66.26	$110.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.37 / $174.55 / $227.32	Professional	TC	$162.37	$174.55	$227.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.00 / $471.00 / $854.46	Professional		$224.00	$471.00	$854.46
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.64 / $124.00 / $216.03	Professional	26	$61.64	$124.00	$216.03
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.37 / $347.00 / $617.22	Professional	TC	$162.37	$347.00	$617.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.50 / $416.55 / $710.05	Professional		$271.50	$416.55	$710.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.23 / $92.62 / $170.02	Professional	26	$64.23	$92.62	$170.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.46 / $338.58 / $552.85	Professional	TC	$204.46	$338.58	$552.85
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $101.25 / $136.00 / $240.00	Facility	26	$101.25	$136.00	$240.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $868.26	Professional		$145.72	$145.72	$868.26
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $245.71 / $245.71 / $245.71	Professional	26	$245.71	$245.71	$245.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.30 / $173.04 / $285.23	Professional		$63.30	$173.04	$285.23
United Facility/Professional Professional Modifier Low / Median / High Price $254.97 / $384.78 / $688.97	Professional		$254.97	$384.78	$688.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.64 / $86.24 / $143.18	Professional	26	$64.64	$86.24	$143.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.61 / $301.74 / $550.23	Professional	TC	$191.61	$301.74	$550.23