Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.33 / $100.33 / $100.33	Facility	26	$100.33	$100.33	$100.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.23 / $425.00 / $522.50	Professional		$311.23	$425.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.33 / $100.33 / $150.09	Professional	26	$82.33	$100.33	$150.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $228.90 / $335.00 / $368.50	Professional	TC	$228.90	$335.00	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.00 / $136.72 / $136.72	Professional	26	$61.00	$136.72	$136.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.93 / $460.00 / $732.50	Professional		$275.93	$460.00	$732.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.38 / $133.54 / $218.15	Professional	26	$76.38	$133.54	$218.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.55 / $292.00 / $584.00	Professional	TC	$199.55	$292.00	$584.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $360.20 / $605.07 / $1,025.96	Professional		$360.20	$605.07	$1,025.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.36 / $109.69 / $211.17	Professional	26	$79.36	$109.69	$211.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $267.20 / $512.74 / $868.68	Professional	TC	$267.20	$512.74	$868.68
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $123.63 / $144.00 / $254.79	Facility	26	$123.63	$144.00	$254.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,145.33	Professional		$300.42	$300.42	$1,145.33
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $302.97 / $302.97 / $302.97	Professional	26	$302.97	$302.97	$302.97
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 $337.02 / $528.01 / $943.83	Professional		$337.02	$528.01	$943.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.90 / $106.54 / $168.68	Professional	26	$79.90	$106.54	$168.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $248.19 / $416.09 / $775.49	Professional	TC	$248.19	$416.09	$775.49