Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $83.00 / $169.45	Facility	26	$83.00	$83.00	$169.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $335.52 / $578.22	Professional		$275.00	$335.52	$578.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $112.87 / $622.50	Professional	26	$55.00	$112.87	$622.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.13 / $220.00 / $292.83	Professional	TC	$169.13	$220.00	$292.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.72 / $113.85 / $189.58	Professional	26	$84.72	$113.85	$189.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $267.33 / $267.33 / $267.33	Professional	TC	$267.33	$267.33	$267.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $296.86 / $775.00 / $1,101.00	Professional		$296.86	$775.00	$1,101.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $105.91 / $183.00 / $259.98	Professional	26	$105.91	$183.00	$259.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.95 / $584.30 / $776.29	Professional	TC	$190.95	$584.30	$776.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $385.33 / $558.87 / $900.64	Professional		$385.33	$558.87	$900.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.32 / $147.41 / $265.10	Professional	26	$118.32	$147.41	$265.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $252.04 / $422.00 / $675.50	Professional	TC	$252.04	$422.00	$675.50
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $165.87 / $166.88 / $333.75	Facility	26	$165.87	$166.88	$333.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $1,037.76	Professional		$145.72	$145.72	$1,037.76
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $622.40 / $622.40 / $622.40	Professional	TC	$622.40	$622.40	$622.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $210.04 / $363.04	Professional		$96.53	$210.04	$363.04
United Facility/Professional Professional Modifier Low / Median / High Price $345.05 / $468.38 / $1,001.86	Professional		$345.05	$468.38	$1,001.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.87 / $146.44 / $242.28	Professional	26	$107.87	$146.44	$242.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $226.06 / $358.17 / $779.07	Professional	TC	$226.06	$358.17	$779.07