Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.31 / $57.31 / $132.86	Facility	26	$57.31	$57.31	$132.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $307.12 / $1,098.00	Professional		$246.93	$307.12	$1,098.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.31 / $94.20 / $357.00	Professional	26	$52.31	$94.20	$357.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $208.50 / $388.49	Professional	TC	$162.34	$208.50	$388.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $233.54 / $326.95	Professional		$94.00	$233.54	$326.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.50 / $71.20 / $91.04	Professional	26	$40.50	$71.20	$91.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $196.38 / $255.75	Professional	TC	$151.36	$196.38	$255.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.54 / $318.00 / $528.57	Professional		$233.54	$318.00	$528.57
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.86 / $127.94 / $176.71	Professional	26	$50.86	$127.94	$176.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.68 / $204.11 / $327.27	Professional	TC	$182.68	$204.11	$327.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.35 / $384.20 / $551.59	Professional		$271.35	$384.20	$551.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.10 / $95.83 / $135.69	Professional	26	$59.10	$95.83	$135.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.08 / $287.83 / $434.09	Professional	TC	$215.08	$287.83	$434.09
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $95.71 / $150.00 / $156.00	Facility	26	$95.71	$150.00	$156.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $954.30 / $954.30 / $954.30	Professional		$954.30	$954.30	$954.30
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $752.27 / $752.27 / $752.27	Professional	TC	$752.27	$752.27	$752.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $239.07 / $374.73	Professional		$44.14	$239.07	$374.73
United Facility/Professional Professional Modifier Low / Median / High Price $245.84 / $340.90 / $561.36	Professional		$245.84	$340.90	$561.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.18 / $83.20 / $141.69	Professional	26	$51.18	$83.20	$141.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.66 / $263.91 / $426.40	Professional	TC	$194.66	$263.91	$426.40