Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $83.00 / $122.83	Facility	26	$83.00	$83.00	$122.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.99 / $275.00 / $407.51	Professional		$229.99	$275.00	$407.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $83.00 / $168.90	Professional	26	$55.00	$83.00	$168.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.25 / $192.00 / $238.57	Professional	TC	$147.25	$192.00	$238.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.83 / $82.53 / $137.41	Professional	26	$60.83	$82.53	$137.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.57 / $405.00 / $575.36	Professional		$209.57	$405.00	$575.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.77 / $101.00 / $165.57	Professional	26	$76.77	$101.00	$165.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.80 / $304.00 / $417.27	Professional	TC	$132.80	$304.00	$417.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.58 / $322.20 / $586.48	Professional		$255.58	$322.20	$586.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.67 / $108.23 / $192.71	Professional	26	$86.67	$108.23	$192.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.62 / $217.35 / $373.19	Professional	TC	$168.62	$217.35	$373.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $121.52 / $122.33 / $244.65	Facility	26	$121.52	$122.33	$244.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $145.72 / $846.36	Professional		$145.72	$145.72	$846.36
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $541.88 / $541.88 / $541.88	Professional	TC	$541.88	$541.88	$541.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $150.80 / $279.41	Professional		$96.53	$150.80	$279.41
United Facility/Professional Professional Modifier Low / Median / High Price $238.90 / $328.89 / $520.16	Professional		$238.90	$328.89	$520.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.78 / $106.54 / $177.54	Professional	26	$78.78	$106.54	$177.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.07 / $211.08 / $347.37	Professional	TC	$151.07	$211.08	$347.37