Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.00 / $83.00 / $83.00	Facility	26	$83.00	$83.00	$83.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.54 / $184.58 / $275.00	Professional		$88.54	$184.58	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $51.30 / $83.00	Professional	26	$11.77	$51.30	$83.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.72 / $166.62 / $220.00	Professional	TC	$76.72	$166.62	$220.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.24 / $148.00 / $199.69	Professional		$89.24	$148.00	$199.69
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $18.00 / $25.57	Professional	26	$11.01	$18.00	$25.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.23 / $130.00 / $175.84	Professional	TC	$78.23	$130.00	$175.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.01 / $150.53 / $279.49	Professional		$114.01	$150.53	$279.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $15.11 / $27.44	Professional	26	$11.28	$15.11	$27.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.94 / $132.68 / $238.33	Professional	TC	$100.94	$132.68	$238.33
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $14.55 / $21.39 / $36.75	Facility	26	$14.55	$21.39	$36.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $65.98 / $65.98 / $325.83	Professional		$65.98	$65.98	$325.83
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $43.53 / $43.53 / $43.53	Professional	26	$43.53	$43.53	$43.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.46 / $104.33 / $154.23	Professional		$76.46	$104.33	$154.23
United Facility/Professional Professional Modifier Low / Median / High Price $106.04 / $146.16 / $246.33	Professional		$106.04	$146.16	$246.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.32 / $14.79 / $25.00	Professional	26	$11.32	$14.79	$25.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.85 / $129.15 / $218.01	Professional	TC	$93.85	$129.15	$218.01