Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $426.58 / $758.58	Professional		$309.03	$426.58	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $117.49 / $194.98	Professional	26	$81.28	$117.49	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $331.13 / $549.54	Professional	TC	$223.87	$331.13	$549.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $77.62 / $141.25	Professional	26	$75.86	$77.62	$141.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $457.09 / $741.31	Professional		$295.12	$457.09	$741.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $112.20 / $208.93	Professional	26	$77.62	$112.20	$208.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $295.12 / $524.81	Professional	TC	$213.80	$295.12	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $588.84 / $1,047.13	Professional		$354.81	$588.84	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $104.71 / $173.78	Professional	26	$79.43	$104.71	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $467.74 / $870.96	Professional	TC	$263.03	$467.74	$870.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $977.24 / $977.24	Professional		$977.24	$977.24	$977.24
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	26	$162.18	$162.18	$162.18
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 $338.84 / $549.54 / $977.24	Professional		$338.84	$549.54	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $169.82	Professional	26	$77.62	$97.72	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $436.52 / $851.14	Professional	TC	$245.47	$436.52	$851.14