Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.21 / $83.00 / $102.92	Facility	26	$41.21	$83.00	$102.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.51 / $165.89 / $275.00	Professional		$66.51	$165.89	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $41.89 / $83.00	Professional	26	$24.03	$41.89	$83.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.50 / $86.51 / $220.00	Professional	TC	$42.50	$86.51	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.64 / $75.64 / $75.64	Professional		$75.64	$75.64	$75.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $20.87 / $29.62	Professional	26	$20.60	$20.87	$29.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $96.44 / $148.83	Professional		$84.00	$96.44	$148.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.76 / $33.49 / $55.15	Professional	26	$25.76	$33.49	$55.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.00 / $66.09 / $99.14	Professional	TC	$51.00	$66.09	$99.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.94 / $123.27 / $237.78	Professional		$86.94	$123.27	$237.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.48 / $35.57 / $64.08	Professional	26	$28.48	$35.57	$64.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.50 / $83.91 / $168.90	Professional	TC	$58.50	$83.91	$168.90
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $39.92 / $40.22 / $80.43	Facility	26	$39.92	$40.22	$80.43
Medcost Facility/Professional Professional Modifier Low / Median / High Price $366.27 / $366.27 / $366.27	Professional		$366.27	$366.27	$366.27
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $264.58 / $264.58 / $264.58	Professional	TC	$264.58	$264.58	$264.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $80.55 / $128.34	Professional		$44.14	$80.55	$128.34
United Facility/Professional Professional Modifier Low / Median / High Price $87.13 / $120.28 / $200.76	Professional		$87.13	$120.28	$200.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $35.60 / $59.08	Professional	26	$25.88	$35.60	$59.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.09 / $90.28 / $142.62	Professional	TC	$60.09	$90.28	$142.62