Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.98 / $76.98 / $106.89	Facility	26	$76.98	$76.98	$106.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.46 / $178.45 / $386.25	Professional		$134.46	$178.45	$386.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $76.98 / $110.22	Professional	26	$56.82	$76.98	$110.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.46 / $112.62 / $266.48	Professional	TC	$57.46	$112.62	$266.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.41 / $91.93 / $91.93	Professional	26	$68.41	$91.93	$91.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.65 / $578.95 / $837.53	Professional		$148.65	$578.95	$837.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.52 / $116.00 / $204.22	Professional	26	$85.52	$116.00	$204.22
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.14 / $393.00 / $639.98	Professional	TC	$63.14	$393.00	$639.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.64 / $284.55 / $664.00	Professional		$177.64	$284.55	$664.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.42 / $97.97 / $210.10	Professional	26	$68.42	$97.97	$210.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.58 / $169.50 / $576.00	Professional	TC	$79.58	$169.50	$576.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $105.61 / $110.00 / $235.00	Facility	26	$105.61	$110.00	$235.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $591.60 / $591.60 / $591.60	Professional		$591.60	$591.60	$591.60
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $253.81 / $253.81 / $253.81	Professional	TC	$253.81	$253.81	$253.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.81 / $112.99 / $201.80	Professional		$60.81	$112.99	$201.80
United Facility/Professional Professional Modifier Low / Median / High Price $169.18 / $257.85 / $563.64	Professional		$169.18	$257.85	$563.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.12 / $97.80 / $175.40	Professional	26	$62.12	$97.80	$175.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.43 / $115.04 / $457.46	Professional	TC	$76.43	$115.04	$457.46