Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.69 / $25.69 / $38.90	Facility	26	$25.69	$25.69	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.62 / $135.83 / $654.00	Professional		$95.62	$135.83	$654.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.26 / $36.56 / $149.44	Professional	26	$23.26	$36.56	$149.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $82.80 / $137.19	Professional	TC	$70.73	$82.80	$137.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.17 / $94.17 / $157.68	Professional		$94.17	$94.17	$157.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.19 / $41.15 / $41.15	Professional	26	$32.19	$41.15	$41.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $90.45 / $90.45 / $90.45	Professional	TC	$90.45	$90.45	$90.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.60 / $142.00 / $249.68	Professional		$87.60	$142.00	$249.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.99 / $55.00 / $96.71	Professional	26	$22.99	$55.00	$96.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.61 / $88.35 / $154.75	Professional	TC	$64.61	$88.35	$154.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.44 / $133.41 / $219.85	Professional		$103.44	$133.41	$219.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.40 / $34.07 / $57.43	Professional	26	$27.40	$34.07	$57.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.94 / $97.96 / $162.41	Professional	TC	$74.94	$97.96	$162.41
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $48.00 / $65.59	Facility	26	$29.51	$48.00	$65.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $351.88 / $351.88 / $351.88	Professional		$351.88	$351.88	$351.88
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $90.86 / $90.86 / $90.86	Professional	26	$90.86	$90.86	$90.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $84.10 / $137.35	Professional		$44.14	$84.10	$137.35
United Facility/Professional Professional Modifier Low / Median / High Price $87.60 / $116.36 / $191.14	Professional		$87.60	$116.36	$191.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $29.23 / $50.27	Professional	26	$22.60	$29.23	$50.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.19 / $83.57 / $135.41	Professional	TC	$63.19	$83.57	$135.41