Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.03 / $149.04 / $183.10	Facility	26	$149.03	$149.04	$183.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $446.99 / $646.92	Professional		$370.50	$446.99	$646.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $149.04 / $250.39	Professional	26	$85.00	$149.04	$250.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $255.88 / $335.00 / $426.57	Professional	TC	$255.88	$335.00	$426.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $355.63 / $355.63 / $355.63	Professional		$355.63	$355.63	$355.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $91.55 / $123.02 / $204.85	Professional	26	$91.55	$123.02	$204.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $330.82 / $660.00 / $931.91	Professional		$330.82	$660.00	$931.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.44 / $179.67 / $275.37	Professional	26	$114.44	$179.67	$275.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $216.38 / $450.00 / $690.32	Professional	TC	$216.38	$450.00	$690.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $422.73 / $646.59 / $1,068.94	Professional		$422.73	$646.59	$1,068.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.58 / $166.89 / $305.38	Professional	26	$124.58	$166.89	$305.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $289.62 / $471.76 / $824.77	Professional	TC	$289.62	$471.76	$824.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $208.65 / $211.79 / $375.15	Facility	26	$208.65	$211.79	$375.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,391.89	Professional		$300.42	$300.42	$1,391.89
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $941.64 / $941.64 / $941.64	Professional	TC	$941.64	$941.64	$941.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $129.28 / $248.65 / $442.85	Professional		$129.28	$248.65	$442.85
United Facility/Professional Professional Modifier Low / Median / High Price $395.78 / $554.54 / $1,056.92	Professional		$395.78	$554.54	$1,056.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.25 / $156.34 / $261.32	Professional	26	$117.25	$156.34	$261.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.54 / $385.32 / $784.37	Professional	TC	$268.54	$385.32	$784.37