Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.99 / $103.99 / $206.80	Facility	26	$103.99	$103.99	$206.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.77 / $425.00 / $496.57	Professional		$282.77	$425.00	$496.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $105.48 / $169.88	Professional	26	$85.00	$105.48	$169.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $197.75 / $299.00 / $366.84	Professional	TC	$197.75	$299.00	$366.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.69 / $85.69 / $142.68	Professional	26	$85.69	$85.69	$142.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $252.09 / $660.00 / $1,012.43	Professional		$252.09	$660.00	$1,012.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.70 / $193.53 / $279.13	Professional	26	$79.70	$193.53	$279.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $172.38 / $450.00 / $806.25	Professional	TC	$172.38	$450.00	$806.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.94 / $585.38 / $1,034.55	Professional		$316.94	$585.38	$1,034.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.05 / $121.21 / $206.72	Professional	26	$88.05	$121.21	$206.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.36 / $466.48 / $788.07	Professional	TC	$223.36	$466.48	$788.07
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $138.65 / $162.00 / $263.11	Facility	26	$138.65	$162.00	$263.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,040.58	Professional		$300.42	$300.42	$1,040.58
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $727.72 / $727.72 / $727.72	Professional	TC	$727.72	$727.72	$727.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $204.24 / $329.95	Professional		$96.53	$204.24	$329.95
United Facility/Professional Professional Modifier Low / Median / High Price $295.52 / $481.00 / $866.73	Professional		$295.52	$481.00	$866.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.33 / $107.46 / $174.17	Professional	26	$83.33	$107.46	$174.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.47 / $335.04 / $748.31	Professional	TC	$211.47	$335.04	$748.31