Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.53 / $30.53 / $30.53	Facility	26	$30.53	$30.53	$30.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.84 / $137.34 / $233.90	Professional		$98.84	$137.34	$233.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $33.57 / $98.79	Professional	26	$28.84	$33.57	$98.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.66 / $104.76 / $171.99	Professional	TC	$90.66	$104.76	$171.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.13 / $36.13 / $36.13	Professional	26	$36.13	$36.13	$36.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.30 / $158.01 / $255.62	Professional		$131.30	$158.01	$255.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $49.00 / $87.67	Professional	26	$33.61	$49.00	$87.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $90.00 / $101.60 / $158.25	Professional	TC	$90.00	$101.60	$158.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.64 / $169.06 / $302.22	Professional		$124.64	$169.06	$302.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $44.82 / $74.45	Professional	26	$34.90	$44.82	$74.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.54 / $125.83 / $228.11	Professional	TC	$88.54	$125.83	$228.11
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $54.08 / $57.80 / $100.14	Facility	26	$54.08	$57.80	$100.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $536.76	Professional		$88.83	$88.83	$536.76
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $132.88 / $132.88 / $132.88	Professional	26	$132.88	$132.88	$132.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $130.87 / $226.10	Professional		$44.14	$130.87	$226.10
United Facility/Professional Professional Modifier Low / Median / High Price $117.56 / $158.22 / $272.68	Professional		$117.56	$158.22	$272.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.26 / $42.25 / $68.58	Professional	26	$32.26	$42.25	$68.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.47 / $119.82 / $204.10	Professional	TC	$90.47	$119.82	$204.10