Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.59 / $128.59 / $230.71	Facility	26	$128.59	$128.59	$230.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.76 / $255.18 / $378.73	Professional		$235.76	$255.18	$378.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.59 / $131.81 / $182.28	Professional	26	$128.59	$131.81	$182.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.17 / $123.37 / $196.43	Professional	TC	$107.17	$123.37	$196.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $286.32 / $286.32 / $286.32	Professional		$286.32	$286.32	$286.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $117.07 / $151.41 / $155.02	Professional	26	$117.07	$151.41	$155.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $266.33 / $302.93 / $568.01	Professional		$266.33	$302.93	$568.01
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $144.19 / $171.13 / $254.58	Professional	26	$144.19	$171.13	$254.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.14 / $137.00 / $320.00	Professional	TC	$122.14	$137.00	$320.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.97 / $374.94 / $557.50	Professional		$291.97	$374.94	$557.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $157.15 / $203.59 / $301.24	Professional	26	$157.15	$203.59	$301.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.60 / $169.34 / $256.51	Professional	TC	$134.60	$169.34	$256.51
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $209.09 / $218.13 / $451.29	Facility	26	$209.09	$218.13	$451.29
Medcost Facility/Professional Professional Modifier Low / Median / High Price $209.53 / $209.53 / $209.53	Professional		$209.53	$209.53	$209.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $121.38 / $196.67 / $363.17	Professional		$121.38	$196.67	$363.17
United Facility/Professional Professional Modifier Low / Median / High Price $256.74 / $374.42 / $573.61	Professional		$256.74	$374.42	$573.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $139.28 / $189.16 / $313.93	Professional	26	$139.28	$189.16	$313.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.46 / $170.99 / $248.34	Professional	TC	$117.46	$170.99	$248.34