Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.96 / $56.40 / $4,982.82	Facility	26	$31.96	$56.40	$4,982.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.22 / $217.70 / $291.22	Professional		$171.22	$217.70	$291.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.35 / $35.21 / $71.94	Professional	26	$30.35	$35.21	$71.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.87 / $185.74 / $235.84	Professional	TC	$140.87	$185.74	$235.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.19 / $257.19 / $275.14	Professional		$257.19	$257.19	$275.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.62 / $52.18 / $63.10	Professional	26	$28.62	$52.18	$63.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.00 / $223.26 / $311.02	Professional		$146.00	$223.26	$311.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.25 / $72.50 / $102.90	Professional	26	$35.25	$72.50	$102.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.50 / $131.44 / $255.01	Professional	TC	$73.50	$131.44	$255.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.79 / $291.82 / $434.66	Professional		$174.79	$291.82	$434.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.47 / $48.40 / $70.94	Professional	26	$35.47	$48.40	$70.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.06 / $244.76 / $370.83	Professional	TC	$141.06	$244.76	$370.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $50.88 / $58.00 / $117.70	Facility	26	$50.88	$58.00	$117.70
Medcost Facility/Professional Professional Modifier Low / Median / High Price $103.51 / $103.51 / $103.51	Professional		$103.51	$103.51	$103.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $249.03 / $395.19	Professional		$45.50	$249.03	$395.19
United Facility/Professional Professional Modifier Low / Median / High Price $159.07 / $285.32 / $537.08	Professional		$159.07	$285.32	$537.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.38 / $47.22 / $75.15	Professional	26	$32.38	$47.22	$75.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $174.02 / $244.98 / $422.98	Professional	TC	$174.02	$244.98	$422.98