Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.46 / $24.47 / $33.36	Facility	26	$24.46	$24.47	$33.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.87 / $81.68 / $171.03	Professional		$71.87	$81.68	$171.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $25.08 / $89.05	Professional	26	$19.89	$25.08	$89.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.19 / $61.79 / $76.95	Professional	TC	$51.19	$61.79	$76.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.31 / $26.70 / $47.79	Professional	26	$21.31	$26.70	$47.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $96.60 / $149.41	Professional		$84.00	$96.60	$149.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.70 / $35.00 / $57.19	Professional	26	$26.70	$35.00	$57.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.00 / $62.32 / $93.23	Professional	TC	$49.00	$62.32	$93.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.41 / $102.02 / $203.20	Professional		$74.41	$102.02	$203.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.95 / $66.44	Professional	26	$23.44	$33.95	$66.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.00 / $72.38 / $136.76	Professional	TC	$53.00	$72.38	$136.76
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $33.76 / $39.00 / $78.59	Facility	26	$33.76	$39.00	$78.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $360.53 / $360.53 / $360.53	Professional		$360.53	$360.53	$360.53
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $255.13 / $255.13 / $255.13	Professional	TC	$255.13	$255.13	$255.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $80.55 / $129.73	Professional		$44.14	$80.55	$129.73
United Facility/Professional Professional Modifier Low / Median / High Price $74.88 / $109.20 / $187.20	Professional		$74.88	$109.20	$187.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.30 / $33.47 / $54.70	Professional	26	$21.30	$33.47	$54.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.31 / $72.93 / $126.08	Professional	TC	$53.31	$72.93	$126.08