Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.60 / $103.60 / $103.60	Facility	26	$103.60	$103.60	$103.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.64 / $425.00 / $494.18	Professional		$277.64	$425.00	$494.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.70 / $118.59 / $157.83	Professional	26	$84.70	$118.59	$157.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.93 / $306.26 / $358.03	Professional	TC	$192.93	$306.26	$358.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $79.42 / $142.16	Professional	26	$64.37	$79.42	$142.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.66 / $660.00 / $1,011.32	Professional		$247.66	$660.00	$1,011.32
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.42 / $194.54 / $295.04	Professional	26	$79.42	$194.54	$295.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $168.24 / $435.00 / $819.28	Professional	TC	$168.24	$435.00	$819.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.91 / $578.60 / $1,008.93	Professional		$317.91	$578.60	$1,008.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.95 / $120.00 / $218.06	Professional	26	$81.95	$120.00	$218.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.20 / $456.91 / $757.00	Professional	TC	$225.20	$456.91	$757.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $127.50 / $150.00 / $262.11	Facility	26	$127.50	$150.00	$262.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $300.42 / $300.42 / $1,021.72	Professional		$300.42	$300.42	$1,021.72
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $311.70 / $311.70 / $311.70	Professional	26	$311.70	$311.70	$311.70
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 $298.48 / $472.52 / $886.75	Professional		$298.48	$472.52	$886.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.18 / $118.12 / $182.28	Professional	26	$82.18	$118.12	$182.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $206.18 / $330.48 / $747.80	Professional	TC	$206.18	$330.48	$747.80