Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.07 / $17.07 / $48.38	Facility	26	$17.07	$17.07	$48.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $80.70 / $141.04	Professional		$73.73	$80.70	$141.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $18.16 / $36.72	Professional	26	$17.07	$18.16	$36.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.21 / $63.62 / $88.54	Professional	TC	$55.21	$63.62	$88.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.25 / $15.25 / $18.73	Professional	26	$15.25	$15.25	$18.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.15 / $100.58 / $182.50	Professional		$88.15	$100.58	$182.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $38.00 / $53.98	Professional	26	$18.80	$38.00	$53.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.00 / $70.18 / $127.19	Professional	TC	$55.00	$70.18	$127.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.75 / $106.44 / $198.88	Professional		$78.75	$106.44	$198.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.94 / $26.12 / $50.03	Professional	26	$20.94	$26.12	$50.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.85 / $77.26 / $154.41	Professional	TC	$59.85	$77.26	$154.41
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $27.27 / $30.33 / $61.09	Facility	26	$27.27	$30.33	$61.09
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $351.99	Professional		$88.83	$88.83	$351.99
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $74.37 / $74.37 / $74.37	Professional	26	$74.37	$74.37	$74.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.96 / $87.39 / $132.83	Professional		$57.96	$87.39	$132.83
United Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $104.20 / $180.17	Professional		$72.06	$104.20	$180.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.11 / $25.55 / $42.49	Professional	26	$19.11	$25.55	$42.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.86 / $77.08 / $137.63	Professional	TC	$52.86	$77.08	$137.63