Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $354.50 / $354.50 / $634.86	Facility	26	$354.50	$354.50	$634.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,489.48 / $1,889.42 / $3,018.54	Professional		$1,489.48	$1,889.42	$3,018.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $347.37 / $398.78 / $761.97	Professional	26	$347.37	$398.78	$761.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,134.98 / $1,475.47 / $2,530.81	Professional	TC	$1,134.98	$1,475.47	$2,530.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,329.38 / $1,786.35 / $2,160.23	Professional		$1,329.38	$1,786.35	$2,160.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $317.43 / $426.55 / $710.25	Professional	26	$317.43	$426.55	$710.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,711.57 / $1,896.00 / $2,834.10	Professional		$1,711.57	$1,896.00	$2,834.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $396.79 / $535.00 / $701.55	Professional	26	$396.79	$535.00	$701.55
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,215.00 / $1,342.33 / $2,136.33	Professional	TC	$1,215.00	$1,342.33	$2,136.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,775.51 / $2,200.83 / $4,141.31	Professional		$1,775.51	$2,200.83	$4,141.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $391.90 / $554.14 / $830.42	Professional	26	$391.90	$554.14	$830.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,274.52 / $1,735.59 / $3,137.24	Professional	TC	$1,274.52	$1,735.59	$3,137.24
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $658.00 / $674.00 / $1,164.18	Facility	26	$658.00	$674.00	$1,164.18
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,030.26 / $1,030.26 / $1,030.26	Professional		$1,030.26	$1,030.26	$1,030.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $382.59 / $1,424.81 / $2,470.86	Professional		$382.59	$1,424.81	$2,470.86
United Facility/Professional Professional Modifier Low / Median / High Price $1,789.02 / $2,519.85 / $3,711.25	Professional		$1,789.02	$2,519.85	$3,711.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $381.66 / $505.45 / $863.87	Professional	26	$381.66	$505.45	$863.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,372.59 / $1,913.69 / $2,847.38	Professional	TC	$1,372.59	$1,913.69	$2,847.38