Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.34 / $34.34 / $56.24	Facility	26	$34.34	$34.34	$56.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.24 / $144.69 / $605.00	Professional		$90.24	$144.69	$605.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.34 / $54.53 / $230.00	Professional	26	$34.34	$54.53	$230.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.89 / $61.99 / $118.51	Professional	TC	$55.89	$61.99	$118.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.28 / $175.29 / $175.92	Professional		$98.28	$175.29	$175.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.21 / $57.79 / $67.61	Professional	26	$30.21	$57.79	$67.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.29 / $80.48 / $108.31	Professional	TC	$55.29	$80.48	$108.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $110.00 / $183.99	Professional		$88.00	$110.00	$183.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.77 / $50.40 / $95.01	Professional	26	$37.77	$50.40	$95.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.00 / $53.96 / $82.75	Professional	TC	$40.00	$53.96	$82.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.24 / $123.56 / $228.25	Professional		$93.24	$123.56	$228.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.79 / $52.45 / $85.27	Professional	26	$38.79	$52.45	$85.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.72 / $74.55 / $146.33	Professional	TC	$46.72	$74.55	$146.33
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $59.57 / $73.00 / $108.64	Facility	26	$59.57	$73.00	$108.64
Medcost Facility/Professional Professional Modifier Low / Median / High Price $395.93 / $395.93 / $395.93	Professional		$395.93	$395.93	$395.93
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $245.68 / $245.68 / $245.68	Professional	TC	$245.68	$245.68	$245.68
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 $91.70 / $117.68 / $205.32	Professional		$91.70	$117.68	$205.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.56 / $47.64 / $77.73	Professional	26	$35.56	$47.64	$77.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.35 / $71.81 / $127.58	Professional	TC	$56.35	$71.81	$127.58