Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.34 / $83.00 / $103.75	Facility	26	$77.34	$83.00	$103.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.85 / $229.86 / $357.50	Professional		$139.85	$229.86	$357.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $83.00 / $386.40	Professional	26	$55.00	$83.00	$386.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.97 / $144.15 / $238.07	Professional	TC	$69.97	$144.15	$238.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.49 / $74.53 / $116.01	Professional	26	$52.49	$74.53	$116.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.57 / $443.00 / $708.75	Professional		$115.57	$443.00	$708.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.81 / $84.00 / $140.66	Professional	26	$64.81	$84.00	$140.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.76 / $247.84 / $457.00	Professional	TC	$50.76	$247.84	$457.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.08 / $210.47 / $369.41	Professional		$133.08	$210.47	$369.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.32 / $77.52 / $173.68	Professional	26	$55.32	$77.52	$173.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.68 / $111.60 / $267.63	Professional	TC	$71.68	$111.60	$267.63
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $68.48 / $95.82 / $194.56	Facility	26	$68.48	$95.82	$194.56
Medcost Facility/Professional Professional Modifier Low / Median / High Price $514.65 / $514.65 / $514.65	Professional		$514.65	$514.65	$514.65
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $257.49 / $257.49 / $257.49	Professional	TC	$257.49	$257.49	$257.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.06 / $105.19 / $182.72	Professional		$59.06	$105.19	$182.72
United Facility/Professional Professional Modifier Low / Median / High Price $138.37 / $199.86 / $382.86	Professional		$138.37	$199.86	$382.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.74 / $83.50 / $144.00	Professional	26	$54.74	$83.50	$144.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.59 / $101.33 / $229.52	Professional	TC	$70.59	$101.33	$229.52