Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $87.10 / $107.15	Facility	26	$70.79	$87.10	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $512.86	Professional		$169.82	$275.42	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $154.88	Professional	26	$54.95	$83.18	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $190.55 / $295.12	Professional	TC	$114.82	$190.55	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $288.40	Professional		$131.83	$154.88	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $100.00	Professional	26	$44.67	$61.66	$100.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $323.59 / $588.84	Professional		$169.82	$323.59	$588.84
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $112.20 / $181.97	Professional	26	$58.88	$112.20	$181.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $194.98 / $407.38	Professional	TC	$109.65	$194.98	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $309.03 / $575.44	Professional		$190.55	$309.03	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $81.28 / $138.04	Professional	26	$58.88	$81.28	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $239.88 / $398.11	Professional	TC	$123.03	$239.88	$398.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	26	$120.23	$120.23	$120.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $295.12 / $524.81	Professional		$177.83	$295.12	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $128.82	Professional	26	$57.54	$72.44	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $208.93 / $407.38	Professional	TC	$117.49	$208.93	$407.38