Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.97 / $49.57 / $70.41	Facility	26	$39.97	$49.57	$70.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.23 / $169.12 / $687.00	Professional		$97.23	$169.12	$687.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $53.50 / $247.50	Professional	26	$39.97	$53.50	$247.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.24 / $74.87 / $131.31	Professional	TC	$57.24	$74.87	$131.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.70 / $189.20 / $189.20	Professional		$105.70	$189.20	$189.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $47.31 / $78.78	Professional	26	$34.95	$47.31	$78.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.35 / $82.05 / $110.43	Professional	TC	$49.35	$82.05	$110.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.55 / $145.88 / $233.63	Professional		$74.55	$145.88	$233.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.01 / $71.00 / $124.84	Professional	26	$44.01	$71.00	$124.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.69 / $78.42 / $156.04	Professional	TC	$61.69	$78.42	$156.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.57 / $153.53 / $256.27	Professional		$119.57	$153.53	$256.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.73 / $62.03 / $98.01	Professional	26	$44.73	$62.03	$98.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.27 / $91.50 / $150.02	Professional	TC	$70.27	$91.50	$150.02
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $70.64 / $84.00 / $125.51	Facility	26	$70.64	$84.00	$125.51
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $424.38	Professional		$88.83	$88.83	$424.38
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $172.81 / $172.81 / $172.81	Professional	26	$172.81	$172.81	$172.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $83.61 / $137.35	Professional		$44.14	$83.61	$137.35
United Facility/Professional Professional Modifier Low / Median / High Price $105.83 / $133.35 / $226.08	Professional		$105.83	$133.35	$226.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.62 / $55.98 / $90.80	Professional	26	$41.62	$55.98	$90.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.57 / $77.79 / $134.88	Professional	TC	$63.57	$77.79	$134.88