Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.09 / $149.93 / $437.51	Facility	26	$127.09	$149.93	$437.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $1,620.10	Professional		$370.50	$475.00	$1,620.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.65 / $127.10 / $544.50	Professional	26	$93.65	$127.10	$544.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $244.56 / $335.00 / $462.42	Professional	TC	$244.56	$335.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $254.48 / $309.32 / $332.52	Professional		$254.48	$309.32	$332.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.93 / $103.59 / $174.81	Professional	26	$77.93	$103.59	$174.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $211.65 / $296.31 / $296.31	Professional	TC	$211.65	$296.31	$296.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.32 / $660.00 / $1,173.96	Professional		$309.32	$660.00	$1,173.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.66 / $174.78 / $344.10	Professional	26	$97.66	$174.78	$344.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $211.65 / $395.00 / $944.29	Professional	TC	$211.65	$395.00	$944.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.90 / $815.77 / $1,455.44	Professional		$400.90	$815.77	$1,455.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.40 / $141.71 / $267.51	Professional	26	$103.40	$141.71	$267.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $285.39 / $607.42 / $1,201.34	Professional	TC	$285.39	$607.42	$1,201.34
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $161.40 / $218.00 / $334.47	Facility	26	$161.40	$218.00	$334.47
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,282.77	Professional		$300.42	$300.42	$1,282.77
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $382.79 / $382.79 / $382.79	Professional	26	$382.79	$382.79	$382.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $243.45 / $407.48	Professional		$96.53	$243.45	$407.48
United Facility/Professional Professional Modifier Low / Median / High Price $366.65 / $592.53 / $1,326.33	Professional		$366.65	$592.53	$1,326.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.70 / $134.26 / $223.92	Professional	26	$100.70	$134.26	$223.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $266.63 / $418.09 / $1,056.48	Professional	TC	$266.63	$418.09	$1,056.48