Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.00 / $40.01 / $70.45	Facility	26	$40.00	$40.01	$70.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.37 / $154.33 / $556.75	Professional		$129.37	$154.33	$556.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.00 / $44.55 / $173.40	Professional	26	$40.00	$44.55	$173.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.37 / $109.93 / $174.38	Professional	TC	$89.37	$109.93	$174.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.56 / $142.91 / $153.63	Professional		$117.56	$142.91	$153.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $47.34 / $78.83	Professional	26	$35.22	$47.34	$78.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.09 / $79.09 / $79.09	Professional	TC	$79.09	$79.09	$79.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $142.91 / $217.40	Professional		$108.00	$142.91	$217.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $46.24 / $68.00	Professional	26	$35.00	$46.24	$68.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.00 / $98.87 / $136.44	Professional	TC	$73.00	$98.87	$136.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.86 / $206.16 / $356.75	Professional		$164.86	$206.16	$356.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.68 / $62.05 / $117.18	Professional	26	$49.68	$62.05	$117.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.13 / $144.11 / $245.76	Professional	TC	$115.13	$144.11	$245.76
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $54.98 / $89.10 / $147.12	Facility	26	$54.98	$89.10	$147.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $569.70 / $569.70 / $569.70	Professional		$569.70	$569.70	$569.70
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $175.09 / $175.09 / $175.09	Professional	26	$175.09	$175.09	$175.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $127.90 / $208.91	Professional		$44.14	$127.90	$208.91
United Facility/Professional Professional Modifier Low / Median / High Price $158.55 / $198.19 / $300.39	Professional		$158.55	$198.19	$300.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.31 / $59.84 / $97.38	Professional	26	$45.31	$59.84	$97.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.93 / $144.65 / $223.48	Professional	TC	$108.93	$144.65	$223.48