Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.87 / $86.87 / $86.87	Facility	26	$86.87	$86.87	$86.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.96 / $406.47 / $494.18	Professional		$250.96	$406.47	$494.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.52 / $86.87 / $145.65	Professional	26	$71.52	$86.87	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $179.44 / $290.19 / $348.53	Professional	TC	$179.44	$290.19	$348.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $53.71 / $53.71	Professional	26	$53.71	$53.71	$53.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.40 / $325.00 / $621.40	Professional		$225.40	$325.00	$621.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.31 / $79.00 / $105.66	Professional	26	$66.31	$79.00	$105.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $159.09 / $246.00 / $514.35	Professional	TC	$159.09	$246.00	$514.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.37 / $534.35 / $864.85	Professional		$302.37	$534.35	$864.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.05 / $83.19 / $182.84	Professional	26	$61.05	$83.19	$182.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.38 / $447.19 / $730.53	Professional	TC	$216.38	$447.19	$730.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $79.00 / $100.00 / $207.87	Facility	26	$79.00	$100.00	$207.87
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $923.53	Professional		$300.42	$300.42	$923.53
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $263.19 / $263.19 / $263.19	Professional	26	$263.19	$263.19	$263.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $178.71 / $320.65	Professional		$96.53	$178.71	$320.65
United Facility/Professional Professional Modifier Low / Median / High Price $267.77 / $454.77 / $790.23	Professional		$267.77	$454.77	$790.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.12 / $85.02 / $153.38	Professional	26	$56.12	$85.02	$153.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.33 / $328.34 / $742.68	Professional	TC	$192.33	$328.34	$742.68