Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $125.89 / $154.88	Facility	26	$123.03	$125.89	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $478.63 / $1,318.26	Professional		$199.53	$478.63	$1,318.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $162.18 / $436.52	Professional	26	$97.72	$162.18	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $389.05 / $831.76	Professional	TC	$288.40	$389.05	$831.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $416.87 / $707.95	Professional		$346.74	$416.87	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $177.83	Professional	26	$77.62	$97.72	$177.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $478.63 / $812.83	Professional		$398.11	$478.63	$812.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $151.36 / $234.42	Professional	26	$100.00	$151.36	$234.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $316.23 / $524.81	Professional	TC	$281.84	$316.23	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $758.58 / $1,445.44	Professional		$478.63	$758.58	$1,445.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $134.90 / $218.78	Professional	26	$97.72	$134.90	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $630.96 / $1,202.26	Professional	TC	$371.54	$630.96	$1,202.26
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Professional		$1,071.52	$1,071.52	$1,071.52
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	26	$204.17	$204.17	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $741.31 / $1,412.54	Professional		$446.68	$741.31	$1,412.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $120.23 / $208.93	Professional	26	$97.72	$120.23	$208.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $588.84 / $1,174.90	Professional	TC	$346.74	$588.84	$1,174.90