Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $83.00 / $98.59	Facility	26	$83.00	$83.00	$98.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.10 / $275.00 / $380.74	Professional		$215.10	$275.00	$380.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $66.63 / $90.99	Professional	26	$55.00	$66.63	$90.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.72 / $210.26 / $306.18	Professional	TC	$154.72	$210.26	$306.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.16 / $60.16 / $100.17	Professional	26	$60.16	$60.16	$100.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $192.04 / $412.00 / $661.68	Professional		$192.04	$412.00	$661.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.96 / $131.00 / $198.75	Professional	26	$55.96	$131.00	$198.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $136.08 / $281.00 / $462.93	Professional	TC	$136.08	$281.00	$462.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.33 / $380.18 / $685.25	Professional		$266.33	$380.18	$685.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.48 / $90.00 / $154.38	Professional	26	$66.48	$90.00	$154.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.76 / $302.38 / $514.15	Professional	TC	$194.76	$302.38	$514.15
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $103.47 / $121.00 / $201.02	Facility	26	$103.47	$121.00	$201.02
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $791.57	Professional		$145.72	$145.72	$791.57
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $569.37 / $569.37 / $569.37	Professional	TC	$569.37	$569.37	$569.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $183.60 / $274.57	Professional		$44.14	$183.60	$274.57
United Facility/Professional Professional Modifier Low / Median / High Price $236.23 / $355.70 / $626.84	Professional		$236.23	$355.70	$626.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.37 / $78.40 / $129.11	Professional	26	$61.37	$78.40	$129.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.75 / $258.02 / $493.48	Professional	TC	$172.75	$258.02	$493.48