Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.70 / $92.70 / $163.74	Facility	26	$92.70	$92.70	$163.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.56 / $475.00 / $1,296.00	Professional		$293.56	$475.00	$1,296.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.70 / $140.00 / $395.25	Professional	26	$92.70	$140.00	$395.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.86 / $259.35 / $422.10	Professional	TC	$200.86	$259.35	$422.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.79 / $313.41 / $336.92	Professional		$257.79	$313.41	$336.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.88 / $110.02 / $183.19	Professional	26	$81.88	$110.02	$183.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $295.48 / $295.48 / $295.48	Professional	TC	$295.48	$295.48	$295.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $313.41 / $660.00 / $1,160.48	Professional		$313.41	$660.00	$1,160.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.34 / $113.96 / $171.00	Professional	26	$102.34	$113.96	$171.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $211.06 / $553.00 / $1,042.00	Professional	TC	$211.06	$553.00	$1,042.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $396.09 / $491.63 / $887.77	Professional		$396.09	$491.63	$887.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.63 / $144.80 / $254.94	Professional	26	$116.63	$144.80	$254.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $278.01 / $332.73 / $583.58	Professional	TC	$278.01	$332.73	$583.58
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $148.38 / $229.05 / $337.89	Facility	26	$148.38	$229.05	$337.89
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,300.35 / $1,300.35 / $1,300.35	Professional		$1,300.35	$1,300.35	$1,300.35
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $899.10 / $899.10 / $899.10	Professional	TC	$899.10	$899.10	$899.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $243.45 / $407.48	Professional		$96.53	$243.45	$407.48
United Facility/Professional Professional Modifier Low / Median / High Price $372.68 / $602.27 / $1,425.06	Professional		$372.68	$602.27	$1,425.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.35 / $129.41 / $232.68	Professional	26	$83.35	$129.41	$232.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $269.85 / $445.96 / $1,163.44	Professional	TC	$269.85	$445.96	$1,163.44