Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.48 / $64.48 / $64.48	Facility	26	$64.48	$64.48	$64.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.80 / $209.31 / $494.18	Professional		$187.80	$209.31	$494.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.48 / $68.34 / $145.65	Professional	26	$64.48	$68.34	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.32 / $143.86 / $348.53	Professional	TC	$123.32	$143.86	$348.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.73 / $70.73 / $70.73	Professional	26	$70.73	$70.73	$70.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.61 / $419.00 / $736.73	Professional		$200.61	$419.00	$736.73
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.73 / $78.75 / $114.92	Professional	26	$70.73	$78.75	$114.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.88 / $344.00 / $654.00	Professional	TC	$129.88	$344.00	$654.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $307.94 / $531.46	Professional		$251.19	$307.94	$531.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.56 / $101.27 / $177.43	Professional	26	$81.56	$101.27	$177.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.62 / $202.79 / $354.03	Professional	TC	$168.62	$202.79	$354.03
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $88.60 / $147.46 / $235.20	Facility	26	$88.60	$147.46	$235.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $187.72 / $187.72 / $827.56	Professional		$187.72	$187.72	$827.56
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $279.45 / $279.45 / $279.45	Professional	26	$279.45	$279.45	$279.45
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 $242.73 / $404.44 / $1,391.70	Professional		$242.73	$404.44	$1,391.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.91 / $98.30 / $163.59	Professional	26	$70.91	$98.30	$163.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.69 / $270.23 / $1,153.89	Professional	TC	$163.69	$270.23	$1,153.89