Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.25 / $40.25 / $70.87	Facility	26	$40.25	$40.25	$70.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.64 / $194.11 / $728.74	Professional		$111.64	$194.11	$728.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.25 / $52.32 / $261.33	Professional	26	$40.25	$52.32	$261.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.39 / $87.95 / $157.44	Professional	TC	$71.39	$87.95	$157.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.12 / $217.16 / $217.16	Professional		$103.12	$217.16	$217.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.88 / $52.78 / $79.30	Professional	26	$35.88	$52.78	$79.30
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $70.38 / $110.14 / $137.87	Professional	TC	$70.38	$110.14	$137.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $121.32 / $161.00 / $262.05	Professional		$121.32	$161.00	$262.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.30 / $71.00 / $115.30	Professional	26	$44.30	$71.00	$115.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.50 / $90.00 / $157.94	Professional	TC	$67.50	$90.00	$157.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.96 / $164.47 / $281.70	Professional		$128.96	$164.47	$281.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.73 / $62.47 / $98.07	Professional	26	$44.73	$62.47	$98.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.18 / $104.40 / $186.84	Professional	TC	$81.18	$104.40	$186.84
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $69.89 / $84.00 / $132.10	Facility	26	$69.89	$84.00	$132.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $487.01	Professional		$88.83	$88.83	$487.01
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $173.99 / $173.99 / $173.99	Professional	26	$173.99	$173.99	$173.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $120.74 / $186.97	Professional		$44.14	$120.74	$186.97
United Facility/Professional Professional Modifier Low / Median / High Price $118.61 / $149.83 / $252.74	Professional		$118.61	$149.83	$252.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.73 / $51.28 / $90.58	Professional	26	$41.73	$51.28	$90.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.33 / $92.78 / $162.16	Professional	TC	$73.33	$92.78	$162.16