Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.22 / $28.22 / $80.45	Facility	26	$28.22	$28.22	$80.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.69 / $74.81 / $112.73	Professional		$64.69	$74.81	$112.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $31.21 / $81.12	Professional	26	$28.22	$31.21	$81.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.15 / $44.21 / $56.32	Professional	TC	$38.15	$44.21	$56.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $31.08 / $33.40	Professional	26	$24.87	$31.08	$33.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.87 / $86.17 / $136.33	Professional		$73.87	$86.17	$136.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.08 / $40.07 / $66.68	Professional	26	$31.08	$40.07	$66.68
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.00 / $45.40 / $66.81	Professional	TC	$38.00	$45.40	$66.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.26 / $99.31 / $175.46	Professional		$81.26	$99.31	$175.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.39 / $44.04 / $77.51	Professional	26	$35.39	$44.04	$77.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.54 / $57.75 / $97.95	Professional	TC	$45.54	$57.75	$97.95
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $51.68 / $51.68 / $92.25	Facility	26	$51.68	$51.68	$92.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $305.92 / $305.92 / $305.92	Professional		$305.92	$305.92	$305.92
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $122.88 / $122.88 / $122.88	Professional	26	$122.88	$122.88	$122.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $52.86 / $125.61	Professional		$28.98	$52.86	$125.61
United Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $98.66 / $159.09	Professional		$74.56	$98.66	$159.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.56 / $43.07 / $67.89	Professional	26	$32.56	$43.07	$67.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.71 / $60.07 / $90.50	Professional	TC	$41.71	$60.07	$90.50