Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.50 / $32.51 / $57.26	Facility	26	$32.50	$32.51	$57.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.71 / $102.06 / $180.86	Professional		$92.71	$102.06	$180.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $34.25 / $182.92	Professional	26	$29.91	$34.25	$182.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.26 / $71.14 / $90.42	Professional	TC	$62.26	$71.14	$90.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.64 / $35.79 / $64.06	Professional	26	$28.64	$35.79	$64.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.00 / $123.74 / $196.93	Professional		$109.00	$123.74	$196.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $46.32 / $76.89	Professional	26	$35.79	$46.32	$76.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.00 / $77.67 / $117.40	Professional	TC	$66.00	$77.67	$117.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.46 / $128.10 / $254.34	Professional		$93.46	$128.10	$254.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $46.00 / $89.59	Professional	26	$33.29	$46.00	$89.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.53 / $87.56 / $164.75	Professional	TC	$61.53	$87.56	$164.75
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $52.40 / $58.00 / $107.24	Facility	26	$52.40	$58.00	$107.24
Medcost Facility/Professional Professional Modifier Low / Median / High Price $143.50 / $143.50 / $452.20	Professional		$143.50	$143.50	$452.20
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $140.32 / $140.32 / $140.32	Professional	26	$140.32	$140.32	$140.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $94.29 / $166.86	Professional		$44.14	$94.29	$166.86
United Facility/Professional Professional Modifier Low / Median / High Price $93.03 / $132.16 / $232.45	Professional		$93.03	$132.16	$232.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.96 / $47.40 / $78.84	Professional	26	$31.96	$47.40	$78.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.24 / $90.14 / $151.88	Professional	TC	$62.24	$90.14	$151.88