Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $83.18 / $104.71	Facility	26	$36.31	$83.18	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $125.89 / $331.13	Professional		$70.79	$125.89	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $42.66 / $83.18	Professional	26	$25.70	$42.66	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $85.11 / $218.78	Professional	TC	$42.66	$85.11	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $91.20	Professional		$75.86	$75.86	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.70 / $45.71	Professional	26	$20.89	$25.70	$45.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $147.91	Professional		$83.18	$100.00	$147.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.11 / $48.98	Professional	26	$26.92	$33.11	$48.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $69.18 / $93.33	Professional	TC	$51.29	$69.18	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $229.09	Professional		$87.10	$125.89	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $35.48 / $67.61	Professional	26	$27.54	$35.48	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $89.13 / $165.96	Professional	TC	$61.66	$89.13	$165.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Professional	26	$53.70	$53.70	$53.70
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 $81.28 / $114.82 / $199.53	Professional		$81.28	$114.82	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.88 / $57.54	Professional	26	$25.70	$33.88	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $81.28 / $144.54	Professional	TC	$54.95	$81.28	$144.54