Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $22.70 / $40.08	Facility	26	$22.69	$22.70	$40.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.06 / $107.25 / $179.78	Professional		$87.06	$107.25	$179.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.48 / $23.64 / $43.25	Professional	26	$21.48	$23.64	$43.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.90 / $84.55 / $126.33	Professional	TC	$69.90	$84.55	$126.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.84 / $20.32 / $44.84	Professional	26	$19.84	$20.32	$44.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.98 / $137.55 / $226.48	Professional		$115.98	$137.55	$226.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $53.00 / $75.29	Professional	26	$25.05	$53.00	$75.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.00 / $94.47 / $141.16	Professional	TC	$78.00	$94.47	$141.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.01 / $136.94 / $252.83	Professional		$103.01	$136.94	$252.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.31 / $36.00 / $60.84	Professional	26	$25.31	$36.00	$60.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.20 / $102.48 / $188.23	Professional	TC	$75.20	$102.48	$188.23
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $39.45 / $46.00 / $79.83	Facility	26	$39.45	$46.00	$79.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $474.61 / $474.61 / $474.61	Professional		$474.61	$474.61	$474.61
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $375.69 / $375.69 / $375.69	Professional	TC	$375.69	$375.69	$375.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $118.03 / $177.87	Professional		$44.14	$118.03	$177.87
United Facility/Professional Professional Modifier Low / Median / High Price $91.44 / $133.35 / $233.11	Professional		$91.44	$133.35	$233.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.28 / $33.78 / $52.66	Professional	26	$25.28	$33.78	$52.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.22 / $102.91 / $177.01	Professional	TC	$66.22	$102.91	$177.01