Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $83.00 / $85.56	Facility	26	$83.00	$83.00	$85.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.40 / $275.00 / $563.50	Professional		$171.40	$275.00	$563.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.21 / $85.57	Professional	26	$52.78	$61.21	$85.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.94 / $220.00 / $489.53	Professional	TC	$139.94	$220.00	$489.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.29 / $95.73 / $95.73	Professional	26	$43.29	$95.73	$95.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.64 / $411.00 / $554.40	Professional		$178.64	$411.00	$554.40
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.48 / $144.00 / $191.40	Professional	26	$53.48	$144.00	$191.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.16 / $267.00 / $360.16	Professional	TC	$125.16	$267.00	$360.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $248.29 / $365.49 / $628.19	Professional		$248.29	$365.49	$628.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $80.13 / $134.51	Professional	26	$55.93	$80.13	$134.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.86 / $296.52 / $483.95	Professional	TC	$179.86	$296.52	$483.95
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $102.00 / $178.30	Facility	26	$80.00	$102.00	$178.30
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $728.49	Professional		$145.72	$145.72	$728.49
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $213.48 / $213.48 / $213.48	Professional	26	$213.48	$213.48	$213.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $161.11 / $253.05	Professional		$44.14	$161.11	$253.05
United Facility/Professional Professional Modifier Low / Median / High Price $222.38 / $314.77 / $571.64	Professional		$222.38	$314.77	$571.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.45 / $78.89 / $125.90	Professional	26	$57.45	$78.89	$125.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.94 / $258.25 / $480.05	Professional	TC	$165.94	$258.25	$480.05