Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.38 / $63.38 / $90.70	Facility	26	$63.38	$63.38	$90.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $317.33 / $1,290.00	Professional		$215.53	$317.33	$1,290.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.34 / $93.31 / $356.22	Professional	26	$58.34	$93.31	$356.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.32 / $159.77 / $273.91	Professional	TC	$147.32	$159.77	$273.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.46 / $208.46 / $208.46	Professional		$208.46	$208.46	$208.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.94 / $101.48 / $101.48	Professional	26	$60.94	$101.48	$101.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.92 / $275.00 / $483.53	Professional		$193.92	$275.00	$483.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.69 / $105.00 / $162.97	Professional	26	$56.69	$105.00	$162.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.22 / $178.50 / $295.60	Professional	TC	$137.22	$178.50	$295.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.22 / $276.58 / $493.74	Professional		$220.22	$276.58	$493.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.09 / $83.93 / $141.68	Professional	26	$67.09	$83.93	$141.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.96 / $190.17 / $352.06	Professional	TC	$150.96	$190.17	$352.06
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $71.09 / $115.00 / $162.49	Facility	26	$71.09	$115.00	$162.49
Medcost Facility/Professional Professional Modifier Low / Median / High Price $800.55 / $800.55 / $800.55	Professional		$800.55	$800.55	$800.55
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $575.26 / $575.26 / $575.26	Professional	TC	$575.26	$575.26	$575.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $186.10 / $292.35	Professional		$44.14	$186.10	$292.35
United Facility/Professional Professional Modifier Low / Median / High Price $189.98 / $237.47 / $375.48	Professional		$189.98	$237.47	$375.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.83 / $74.65 / $116.68	Professional	26	$56.83	$74.65	$116.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.54 / $172.15 / $266.64	Professional	TC	$132.54	$172.15	$266.64