Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.19 / $34.95 / $79.70	Facility	26	$28.19	$34.95	$79.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.29 / $142.04 / $687.65	Professional		$98.29	$142.04	$687.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.19 / $47.08 / $225.60	Professional	26	$28.19	$47.08	$225.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.52 / $52.86 / $249.00	Professional	52	$39.52	$52.86	$249.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.09 / $83.59 / $173.42	Professional	TC	$70.09	$83.59	$173.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.89 / $184.61 / $189.81	Professional		$96.89	$184.61	$189.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.60 / $35.40 / $55.11	Professional	26	$24.60	$35.40	$55.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.20 / $75.25 / $80.89	Professional	TC	$60.20	$75.25	$80.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.04 / $135.40 / $243.00	Professional		$106.04	$135.40	$243.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.79 / $80.00 / $121.72	Professional	26	$30.79	$80.00	$121.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.00 / $75.25 / $167.00	Professional	TC	$35.00	$75.25	$167.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.71 / $137.72 / $245.00	Professional		$99.71	$137.72	$245.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.58 / $43.57 / $68.08	Professional	26	$31.58	$43.57	$68.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.07 / $92.86 / $180.35	Professional	TC	$63.07	$92.86	$180.35
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $48.66 / $58.00 / $100.74	Facility	26	$48.66	$58.00	$100.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $432.25	Professional		$88.83	$88.83	$432.25
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $121.59 / $121.59 / $121.59	Professional	26	$121.59	$121.59	$121.59
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 $97.68 / $129.51 / $221.28	Professional		$97.68	$129.51	$221.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.00 / $37.67 / $66.42	Professional	26	$29.00	$37.67	$66.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.88 / $90.85 / $158.52	Professional	TC	$71.88	$90.85	$158.52