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 / $123.20	Facility	26	$83.00	$83.00	$123.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.73 / $275.00 / $545.91	Professional		$185.73	$275.00	$545.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.87 / $85.73 / $253.25	Professional	26	$72.87	$85.73	$253.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.65 / $192.00 / $238.07	Professional	TC	$105.65	$192.00	$238.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.15 / $173.06 / $182.40	Professional		$139.15	$173.06	$182.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.06 / $82.78 / $137.83	Professional	26	$61.06	$82.78	$137.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $99.62 / $110.28 / $129.74	Professional	TC	$99.62	$110.28	$129.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.67 / $561.25 / $866.10	Professional		$169.67	$561.25	$866.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.00 / $237.50 / $325.20	Professional	26	$77.00	$237.50	$325.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.67 / $323.74 / $542.27	Professional	TC	$92.67	$323.74	$542.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.69 / $261.64 / $464.35	Professional		$199.69	$261.64	$464.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.87 / $108.42 / $197.09	Professional	26	$85.87	$108.42	$197.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.30 / $147.51 / $261.67	Professional	TC	$111.30	$147.51	$261.67
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $122.67 / $123.87 / $255.88	Facility	26	$122.67	$123.87	$255.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $174.60 / $174.60 / $683.49	Professional		$174.60	$174.60	$683.49
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $379.22 / $379.22 / $379.22	Professional	TC	$379.22	$379.22	$379.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.68 / $124.33 / $239.12	Professional		$85.68	$124.33	$239.12
United Facility/Professional Professional Modifier Low / Median / High Price $189.11 / $264.13 / $403.22	Professional		$189.11	$264.13	$403.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.39 / $107.21 / $177.93	Professional	26	$81.39	$107.21	$177.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.06 / $143.51 / $227.92	Professional	TC	$104.06	$143.51	$227.92