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 / $140.47	Facility	26	$83.00	$83.00	$140.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.34 / $275.00 / $450.50	Professional		$171.34	$275.00	$450.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $63.42 / $112.84	Professional	26	$52.46	$63.42	$112.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $115.86 / $214.72 / $377.04	Professional	TC	$115.86	$214.72	$377.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.54 / $57.81 / $96.27	Professional	26	$43.54	$57.81	$96.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.72 / $395.00 / $628.76	Professional		$154.72	$395.00	$628.76
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.78 / $140.00 / $202.66	Professional	26	$53.78	$140.00	$202.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.94 / $255.00 / $448.37	Professional	TC	$100.94	$255.00	$448.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.31 / $312.10 / $565.95	Professional		$209.31	$312.10	$565.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.59 / $80.28 / $148.44	Professional	26	$55.59	$80.28	$148.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.11 / $252.16 / $434.84	Professional	TC	$140.11	$252.16	$434.84
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $88.28 / $102.00 / $180.48	Facility	26	$88.28	$102.00	$180.48
Medcost Facility/Professional Professional Modifier Low / Median / High Price $192.06 / $192.06 / $630.53	Professional		$192.06	$192.06	$630.53
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $213.48 / $213.48 / $213.48	Professional	26	$213.48	$213.48	$213.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $127.90 / $207.66	Professional		$44.14	$127.90	$207.66
United Facility/Professional Professional Modifier Low / Median / High Price $187.01 / $274.48 / $490.06	Professional		$187.01	$274.48	$490.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.14 / $72.93 / $124.70	Professional	26	$53.14	$72.93	$124.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.25 / $214.62 / $430.48	Professional	TC	$129.25	$214.62	$430.48