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 / $167.98	Facility	26	$83.00	$83.00	$167.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $358.72 / $515.60	Professional		$275.00	$358.72	$515.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $110.81 / $229.59	Professional	26	$55.00	$110.81	$229.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.17 / $241.25 / $380.16	Professional	TC	$169.17	$241.25	$380.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $267.35 / $267.35 / $309.29	Professional		$267.35	$267.35	$309.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.99 / $104.99 / $187.93	Professional	26	$83.99	$104.99	$187.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $227.32 / $227.32 / $227.32	Professional	TC	$227.32	$227.32	$227.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.35 / $412.00 / $724.42	Professional		$267.35	$412.00	$724.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.00 / $111.38 / $181.43	Professional	26	$102.00	$111.38	$181.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.37 / $310.00 / $475.01	Professional	TC	$162.37	$310.00	$475.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $419.96 / $601.16 / $1,080.72	Professional		$419.96	$601.16	$1,080.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.21 / $152.86 / $262.32	Professional	26	$111.21	$152.86	$262.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $289.50 / $472.00 / $800.03	Professional	TC	$289.50	$472.00	$800.03
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $175.23 / $201.00 / $347.54	Facility	26	$175.23	$201.00	$347.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,035.36 / $1,035.36 / $1,035.36	Professional		$1,035.36	$1,035.36	$1,035.36
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $412.86 / $412.86 / $412.86	Professional	26	$412.86	$412.86	$412.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $178.71 / $320.65	Professional		$96.53	$178.71	$320.65
United Facility/Professional Professional Modifier Low / Median / High Price $415.46 / $585.99 / $986.22	Professional		$415.46	$585.99	$986.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $111.23 / $145.74 / $238.74	Professional	26	$111.23	$145.74	$238.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $298.87 / $416.54 / $742.78	Professional	TC	$298.87	$416.54	$742.78