Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.59 / $83.00 / $140.47	Facility	26	$80.59	$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 $52.78 / $62.09 / $107.90	Professional	26	$52.78	$62.09	$107.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.19 / $220.00 / $326.93	Professional	TC	$116.19	$220.00	$326.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.61 / $53.78 / $81.42	Professional	26	$42.61	$53.78	$81.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.31 / $395.00 / $673.75	Professional		$155.31	$395.00	$673.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.78 / $145.00 / $195.02	Professional	26	$53.78	$145.00	$195.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.53 / $250.00 / $439.58	Professional	TC	$101.53	$250.00	$439.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $211.30 / $311.76 / $550.41	Professional		$211.30	$311.76	$550.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.59 / $80.93 / $148.44	Professional	26	$55.59	$80.93	$148.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.16 / $250.08 / $433.57	Professional	TC	$142.16	$250.08	$433.57
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $87.41 / $102.00 / $181.47	Facility	26	$87.41	$102.00	$181.47
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 $187.34 / $274.48 / $490.06	Professional		$187.34	$274.48	$490.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.20 / $75.11 / $124.70	Professional	26	$56.20	$75.11	$124.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.15 / $209.12 / $393.58	Professional	TC	$126.15	$209.12	$393.58