Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.92 / $32.14 / $45.26	Facility	26	$25.92	$32.14	$45.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.89 / $125.23 / $676.00	Professional		$82.89	$125.23	$676.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.92 / $38.97 / $229.91	Professional	26	$25.92	$38.97	$229.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.96 / $84.53 / $138.75	Professional	TC	$56.96	$84.53	$138.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.95 / $96.70 / $157.41	Professional		$71.95	$96.70	$157.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.63 / $31.12 / $50.64	Professional	26	$22.63	$31.12	$50.64
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $86.32 / $86.32	Professional	TC	$61.66	$86.32	$86.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.95 / $116.52 / $234.17	Professional		$89.95	$116.52	$234.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.29 / $50.00 / $88.76	Professional	26	$28.29	$50.00	$88.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $68.98 / $134.90	Professional	TC	$61.66	$68.98	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.02 / $114.40 / $218.49	Professional		$78.02	$114.40	$218.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.34 / $40.26 / $63.25	Professional	26	$29.34	$40.26	$63.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.94 / $74.34 / $151.84	Professional	TC	$44.94	$74.34	$151.84
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $45.78 / $54.00 / $81.61	Facility	26	$45.78	$54.00	$81.61
Medcost Facility/Professional Professional Modifier Low / Median / High Price $364.43 / $364.43 / $364.43	Professional		$364.43	$364.43	$364.43
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $112.87 / $112.87 / $112.87	Professional	26	$112.87	$112.87	$112.87
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 $82.26 / $117.22 / $185.80	Professional		$82.26	$117.22	$185.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $33.72 / $61.21	Professional	26	$26.85	$33.72	$61.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.23 / $79.55 / $137.57	Professional	TC	$57.23	$79.55	$137.57