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 $197.33 / $275.00 / $342.37	Professional		$197.33	$275.00	$342.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.83 / $60.67 / $83.00	Professional	26	$53.83	$60.67	$83.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.27 / $192.00 / $287.81	Professional	TC	$140.27	$192.00	$287.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.98 / $55.96 / $60.16	Professional	26	$27.98	$55.96	$60.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.22 / $477.00 / $792.50	Professional		$180.22	$477.00	$792.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.96 / $84.00 / $194.25	Professional	26	$55.96	$84.00	$194.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $124.27 / $187.00 / $495.00	Professional	TC	$124.27	$187.00	$495.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.88 / $381.33 / $675.00	Professional		$246.88	$381.33	$675.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.33 / $85.00 / $155.19	Professional	26	$58.33	$85.00	$155.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $175.30 / $315.45 / $543.29	Professional	TC	$175.30	$315.45	$543.29
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $107.00 / $185.58	Facility	26	$91.04	$107.00	$185.58
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $739.42	Professional		$145.72	$145.72	$739.42
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $223.27 / $223.27 / $223.27	Professional	26	$223.27	$223.27	$223.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $161.11 / $253.05	Professional		$44.14	$161.11	$253.05
United Facility/Professional Professional Modifier Low / Median / High Price $218.97 / $346.94 / $596.94	Professional		$218.97	$346.94	$596.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.14 / $77.52 / $129.12	Professional	26	$58.14	$77.52	$129.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.43 / $260.67 / $494.89	Professional	TC	$155.43	$260.67	$494.89