Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.79 / $84.79 / $105.13	Facility	26	$84.79	$84.79	$105.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.80 / $425.00 / $630.00	Professional		$200.80	$425.00	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $115.46 / $322.00	Professional	26	$66.28	$115.46	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $156.02 / $299.00 / $422.10	Professional	TC	$156.02	$299.00	$422.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $176.17 / $176.17 / $176.17	Professional		$176.17	$176.17	$176.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.45 / $68.36 / $115.33	Professional	26	$51.45	$68.36	$115.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $161.15 / $161.15 / $161.15	Professional	TC	$161.15	$161.15	$161.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.55 / $460.00 / $781.51	Professional		$179.55	$460.00	$781.51
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.43 / $168.00 / $255.08	Professional	26	$64.43	$168.00	$255.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $115.11 / $292.00 / $537.76	Professional	TC	$115.11	$292.00	$537.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.08 / $470.51 / $806.65	Professional		$241.08	$470.51	$806.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.20 / $94.21 / $178.47	Professional	26	$67.20	$94.21	$178.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.24 / $342.30 / $666.98	Professional	TC	$160.24	$342.30	$666.98
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $104.00 / $122.00 / $216.12	Facility	26	$104.00	$122.00	$216.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $738.94	Professional		$187.72	$187.72	$738.94
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $255.72 / $255.72 / $255.72	Professional	26	$255.72	$255.72	$255.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $130.32 / $212.63	Professional		$63.54	$130.32	$212.63
United Facility/Professional Professional Modifier Low / Median / High Price $220.06 / $361.68 / $726.21	Professional		$220.06	$361.68	$726.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.56 / $90.21 / $149.71	Professional	26	$67.56	$90.21	$149.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.97 / $237.90 / $620.42	Professional	TC	$144.97	$237.90	$620.42