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 / $83.00	Facility	26	$83.00	$83.00	$83.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.62 / $275.00 / $451.52	Professional		$172.62	$275.00	$451.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.64 / $106.83	Professional	26	$52.78	$61.64	$106.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.29 / $218.26 / $377.54	Professional	TC	$114.29	$218.26	$377.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.23 / $54.04 / $66.83	Professional	26	$43.23	$54.04	$66.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $156.16 / $395.00 / $571.79	Professional		$156.16	$395.00	$571.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.04 / $164.00 / $213.90	Professional	26	$54.04	$164.00	$213.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $102.12 / $231.00 / $380.81	Professional	TC	$102.12	$231.00	$380.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.85 / $312.44 / $565.95	Professional		$210.85	$312.44	$565.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $80.59 / $149.11	Professional	26	$55.93	$80.59	$149.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.59 / $253.76 / $434.84	Professional	TC	$141.59	$253.76	$434.84
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $87.41 / $102.00 / $179.27	Facility	26	$87.41	$102.00	$179.27
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $635.24	Professional		$145.72	$145.72	$635.24
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $214.65 / $214.65 / $214.65	Professional	26	$214.65	$214.65	$214.65
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 $188.41 / $294.35 / $486.30	Professional		$188.41	$294.35	$486.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.20 / $72.93 / $124.70	Professional	26	$56.20	$72.93	$124.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.62 / $201.38 / $393.58	Professional	TC	$130.62	$201.38	$393.58