Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.65 / $126.65 / $243.71	Facility	26	$126.65	$126.65	$243.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $572.95 / $734.13 / $1,289.30	Professional		$572.95	$734.13	$1,289.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.16 / $137.93 / $622.05	Professional	26	$108.16	$137.93	$622.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $205.46 / $316.20 / $388.94	Professional	52	$205.46	$316.20	$388.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $455.27 / $585.46 / $1,006.84	Professional	TC	$455.27	$585.46	$1,006.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $588.29 / $632.41 / $632.41	Professional		$588.29	$632.41	$632.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $115.24 / $203.90 / $205.04	Professional	26	$115.24	$203.90	$205.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $509.96 / $509.96 / $849.14	Professional	TC	$509.96	$509.96	$849.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $573.00 / $662.37 / $1,073.58	Professional		$573.00	$662.37	$1,073.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.91 / $273.00 / $387.84	Professional	26	$113.91	$273.00	$387.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $300.00 / $474.38 / $689.77	Professional	TC	$300.00	$474.38	$689.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.73 / $885.43 / $1,266.24	Professional		$663.73	$885.43	$1,266.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $136.94 / $198.76 / $265.02	Professional	26	$136.94	$198.76	$265.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $526.79 / $698.27 / $1,015.73	Professional	TC	$526.79	$698.27	$1,015.73
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $165.17 / $224.00 / $308.56	Facility	26	$165.17	$224.00	$308.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $133.98 / $548.48 / $921.40	Professional		$133.98	$548.48	$921.40
United Facility/Professional Professional Modifier Low / Median / High Price $584.00 / $746.22 / $1,152.92	Professional		$584.00	$746.22	$1,152.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.73 / $149.99 / $235.64	Professional	26	$115.73	$149.99	$235.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $461.29 / $589.23 / $908.99	Professional	TC	$461.29	$589.23	$908.99