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 / $129.59	Facility	26	$83.00	$83.00	$129.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $353.68 / $1,564.00	Professional		$275.00	$353.68	$1,564.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.16 / $106.65 / $692.00	Professional	26	$77.16	$106.65	$692.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.00 / $238.07 / $468.00	Professional	TC	$192.00	$238.07	$468.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $276.14 / $296.86 / $359.00	Professional		$276.14	$296.86	$359.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.80 / $87.08 / $144.99	Professional	26	$64.80	$87.08	$144.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $195.15 / $273.20 / $273.20	Professional	TC	$195.15	$273.20	$273.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.14 / $770.00 / $1,109.08	Professional		$276.14	$770.00	$1,109.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.00 / $216.00 / $291.36	Professional	26	$81.00	$216.00	$291.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $195.15 / $554.00 / $768.15	Professional	TC	$195.15	$554.00	$768.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.82 / $420.02 / $732.54	Professional		$314.82	$420.02	$732.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.08 / $112.74 / $205.87	Professional	26	$90.08	$112.74	$205.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.39 / $301.98 / $514.36	Professional	TC	$220.39	$301.98	$514.36
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $128.69 / $129.90 / $268.33	Facility	26	$128.69	$129.90	$268.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,153.24	Professional		$300.42	$300.42	$1,153.24
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $834.07 / $834.07 / $834.07	Professional	TC	$834.07	$834.07	$834.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $231.94 / $375.78	Professional		$96.53	$231.94	$375.78
United Facility/Professional Professional Modifier Low / Median / High Price $299.83 / $390.57 / $635.74	Professional		$299.83	$390.57	$635.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.38 / $112.47 / $186.64	Professional	26	$85.38	$112.47	$186.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.28 / $281.14 / $448.94	Professional	TC	$215.28	$281.14	$448.94