Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.73 / $41.73 / $119.17	Facility	26	$41.73	$41.73	$119.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $130.80 / $185.74	Professional		$109.45	$130.80	$185.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $42.63 / $108.11	Professional	26	$29.91	$42.63	$108.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.52 / $93.58 / $140.02	Professional	TC	$78.52	$93.58	$140.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.93 / $81.66 / $81.66	Professional	26	$36.93	$81.66	$81.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $145.22 / $218.92	Professional		$124.00	$145.22	$218.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.62 / $51.93 / $80.15	Professional	26	$45.62	$51.93	$80.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.00 / $94.26 / $141.21	Professional	TC	$77.00	$94.26	$141.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.08 / $168.16 / $307.62	Professional		$119.08	$168.16	$307.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.06 / $48.13 / $89.50	Professional	26	$35.06	$48.13	$89.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.93 / $126.67 / $233.78	Professional	TC	$76.93	$126.67	$233.78
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $55.01 / $58.00 / $104.82	Facility	26	$55.01	$58.00	$104.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $567.71 / $567.71 / $567.71	Professional		$567.71	$567.71	$567.71
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $386.33 / $386.33 / $386.33	Professional	TC	$386.33	$386.33	$386.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $118.03 / $177.87	Professional		$44.14	$118.03	$177.87
United Facility/Professional Professional Modifier Low / Median / High Price $124.82 / $172.82 / $297.60	Professional		$124.82	$172.82	$297.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.52 / $56.35 / $93.84	Professional	26	$32.52	$56.35	$93.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.35 / $116.88 / $194.67	Professional	TC	$92.35	$116.88	$194.67