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 / $155.74	Facility	26	$83.00	$83.00	$155.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $460.21 / $918.81	Professional		$275.00	$460.21	$918.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.00 / $103.31 / $669.50	Professional	26	$83.00	$103.31	$669.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.00 / $308.85 / $657.20	Professional	TC	$192.00	$308.85	$657.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $373.40 / $373.40 / $373.40	Professional		$373.40	$373.40	$373.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.87 / $103.26 / $174.24	Professional	26	$77.87	$103.26	$174.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $250.01 / $250.01 / $350.01	Professional	TC	$250.01	$250.01	$350.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $347.35 / $834.90 / $1,247.99	Professional		$347.35	$834.90	$1,247.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.34 / $187.59 / $382.80	Professional	26	$97.34	$187.59	$382.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $250.01 / $576.71 / $802.84	Professional	TC	$250.01	$576.71	$802.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $390.43 / $593.55 / $1,045.91	Professional		$390.43	$593.55	$1,045.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.07 / $136.15 / $248.07	Professional	26	$107.07	$136.15	$248.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $286.77 / $459.32 / $842.02	Professional	TC	$286.77	$459.32	$842.02
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $141.60 / $242.57 / $378.35	Facility	26	$141.60	$242.57	$378.35
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,427.99	Professional		$300.42	$300.42	$1,427.99
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $1,046.52 / $1,046.52 / $1,046.52	Professional	TC	$1,046.52	$1,046.52	$1,046.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $274.12 / $451.26	Professional		$96.53	$274.12	$451.26
United Facility/Professional Professional Modifier Low / Median / High Price $379.11 / $556.44 / $907.55	Professional		$379.11	$556.44	$907.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $101.17 / $136.36 / $223.48	Professional	26	$101.17	$136.36	$223.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $271.38 / $404.46 / $727.17	Professional	TC	$271.38	$404.46	$727.17