Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.18 / $85.18 / $199.18	Facility	26	$85.18	$85.18	$199.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.11 / $303.48 / $1,117.00	Professional		$228.11	$303.48	$1,117.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.72 / $110.73 / $366.33	Professional	26	$78.72	$110.73	$366.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.07 / $165.09 / $279.43	Professional	TC	$144.07	$165.09	$279.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.42 / $223.42 / $316.95	Professional		$223.42	$223.42	$316.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.96 / $109.02 / $136.47	Professional	26	$81.96	$109.02	$136.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.83 / $318.00 / $529.39	Professional		$207.83	$318.00	$529.39
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.23 / $130.00 / $200.14	Professional	26	$76.23	$130.00	$200.14
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.59 / $188.00 / $312.77	Professional	TC	$131.59	$188.00	$312.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.15 / $323.14 / $521.87	Professional		$247.15	$323.14	$521.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.62 / $119.71 / $190.43	Professional	26	$91.62	$119.71	$190.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.50 / $196.35 / $331.45	Professional	TC	$148.50	$196.35	$331.45
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $99.18 / $108.19 / $183.00	Facility	26	$99.18	$108.19	$183.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $839.44 / $839.44 / $839.44	Professional		$839.44	$839.44	$839.44
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $535.99 / $535.99 / $535.99	Professional	TC	$535.99	$535.99	$535.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $159.47 / $296.28	Professional		$97.00	$159.47	$296.28
United Facility/Professional Professional Modifier Low / Median / High Price $208.16 / $267.17 / $440.63	Professional		$208.16	$267.17	$440.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.98 / $101.38 / $167.23	Professional	26	$75.98	$101.38	$167.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.13 / $165.81 / $275.70	Professional	TC	$129.13	$165.81	$275.70