Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $602.56 / $1,047.13	Facility		$144.54	$602.56	$1,047.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $28.84 / $34.67	Facility	26	$21.88	$28.84	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $363.08	Professional		$72.44	$112.20	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $26.92 / $87.10	Professional	26	$21.88	$26.92	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $75.86 / $134.90	Professional	TC	$50.12	$75.86	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $165.96	Professional		$81.28	$95.50	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.92 / $33.11	Professional	26	$19.95	$26.92	$33.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $162.18	Professional		$95.50	$117.49	$162.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $35.48 / $93.33	Professional	26	$26.30	$35.48	$93.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $87.10 / $107.15	Professional	TC	$22.91	$87.10	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $302.00 / $302.00	Facility		$173.78	$302.00	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $114.82 / $194.98	Professional		$74.13	$114.82	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $33.11 / $54.95	Professional	26	$26.30	$33.11	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $81.28 / $147.91	Professional	TC	$46.77	$81.28	$147.91
Medcost Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $114.82 / $234.42	Facility		$75.86	$114.82	$234.42
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 $63.10 / $102.33 / $173.78	Professional		$63.10	$102.33	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.18 / $46.77	Professional	26	$22.91	$28.18	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $74.13 / $125.89	Professional	TC	$40.74	$74.13	$125.89