Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.28 / $42.28 / $75.42	Facility	26	$42.28	$42.28	$75.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $95.59 / $147.15	Professional		$77.31	$95.59	$147.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $42.36 / $60.85	Professional	26	$40.96	$42.36	$60.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.02 / $45.52 / $89.64	Professional	TC	$35.02	$45.52	$89.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.71 / $50.68 / $72.12	Professional	26	$37.71	$50.68	$72.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $252.00 / $367.50	Professional		$86.98	$252.00	$367.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $90.00 / $121.40	Professional	26	$47.14	$90.00	$121.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.84 / $145.41 / $248.76	Professional	TC	$39.84	$145.41	$248.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.57 / $143.69 / $299.45	Professional		$96.57	$143.69	$299.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.26 / $65.66 / $96.05	Professional	26	$47.26	$65.66	$96.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.16 / $74.04 / $196.28	Professional	TC	$44.16	$74.04	$196.28
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $78.00 / $80.00 / $149.71	Facility	26	$78.00	$80.00	$149.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $69.28 / $69.28 / $69.28	Professional		$69.28	$69.28	$69.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.34 / $71.48 / $124.04	Professional		$30.34	$71.48	$124.04
United Facility/Professional Professional Modifier Low / Median / High Price $90.30 / $133.29 / $254.98	Professional		$90.30	$133.29	$254.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.70 / $62.68 / $104.01	Professional	26	$43.70	$62.68	$104.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.15 / $62.53 / $128.71	Professional	TC	$40.15	$62.53	$128.71