Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.50 / $23.50 / $68.40	Facility	26	$23.50	$23.50	$68.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $108.53 / $143.22	Professional		$90.73	$108.53	$143.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $25.27 / $53.45	Professional	26	$22.46	$25.27	$53.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $82.94 / $109.09	Professional	TC	$66.45	$82.94	$109.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.82 / $131.00 / $177.14	Professional		$111.82	$131.00	$177.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.91 / $39.00 / $59.76	Professional	26	$25.91	$39.00	$59.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.45 / $90.21 / $118.56	Professional	TC	$63.45	$90.21	$118.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.64 / $135.27 / $258.07	Professional		$97.64	$135.27	$258.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.64 / $36.46 / $64.79	Professional	26	$25.64	$36.46	$64.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.53 / $98.88 / $189.03	Professional	TC	$70.53	$98.88	$189.03
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $39.53 / $46.00 / $80.48	Facility	26	$39.53	$46.00	$80.48
Medcost Facility/Professional Professional Modifier Low / Median / High Price $482.74 / $482.74 / $482.74	Professional		$482.74	$482.74	$482.74
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $103.52 / $103.52 / $103.52	Professional	26	$103.52	$103.52	$103.52
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 $86.54 / $137.74 / $232.18	Professional		$86.54	$137.74	$232.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.43 / $37.09 / $78.81	Professional	26	$25.43	$37.09	$78.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.34 / $102.70 / $175.96	Professional	TC	$62.34	$102.70	$175.96