Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $34.63 / $48.78	Facility	26	$27.92	$34.63	$48.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.77 / $125.62 / $595.85	Professional		$86.77	$125.62	$595.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.93 / $38.02 / $198.70	Professional	26	$27.93	$38.02	$198.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.85 / $83.28 / $136.69	Professional	TC	$58.85	$83.28	$136.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $104.92 / $169.19	Professional		$76.23	$104.92	$169.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $32.78 / $54.58	Professional	26	$24.20	$32.78	$54.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.22 / $68.81 / $91.55	Professional	TC	$51.22	$68.81	$91.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.52 / $128.81 / $205.52	Professional		$94.52	$128.81	$205.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.49 / $62.00 / $104.32	Professional	26	$30.49	$62.00	$104.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.00 / $67.22 / $112.91	Professional	TC	$54.00	$67.22	$112.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.13 / $127.28 / $228.73	Professional		$96.13	$127.28	$228.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.58 / $43.16 / $67.48	Professional	26	$31.58	$43.16	$67.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.28 / $86.78 / $156.40	Professional	TC	$62.28	$86.78	$156.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $49.40 / $58.00 / $90.79	Facility	26	$49.40	$58.00	$90.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $382.65	Professional		$88.83	$88.83	$382.65
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $261.06 / $261.06 / $261.06	Professional	TC	$261.06	$261.06	$261.06
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 $94.79 / $119.84 / $207.08	Professional		$94.79	$119.84	$207.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.88 / $38.82 / $66.52	Professional	26	$28.88	$38.82	$66.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.76 / $82.19 / $138.04	Professional	TC	$62.76	$82.19	$138.04