Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.83 / $128.22 / $709.48	Professional		$111.83	$128.22	$709.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.20 / $47.91 / $257.12	Professional	26	$43.20	$47.91	$257.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.63 / $80.33 / $452.37	Professional	TC	$68.63	$80.33	$452.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.37 / $116.06 / $140.35	Professional		$86.37	$116.06	$140.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.55 / $75.95 / $75.95	Professional	26	$44.55	$75.95	$75.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.20 / $189.00 / $251.22	Professional		$111.20	$189.00	$251.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.43 / $80.00 / $109.99	Professional	26	$42.43	$80.00	$109.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.50 / $109.00 / $144.88	Professional	TC	$67.50	$109.00	$144.88
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $50.54 / $79.18 / $132.51	Facility	26	$50.54	$79.18	$132.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $97.89 / $174.27	Professional		$45.50	$97.89	$174.27
United Facility/Professional Professional Modifier Low / Median / High Price $115.37 / $161.86 / $284.18	Professional		$115.37	$161.86	$284.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.15 / $55.56 / $92.21	Professional	26	$39.15	$55.56	$92.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.92 / $114.61 / $206.64	Professional	TC	$70.92	$114.61	$206.64