Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.85 / $50.86 / $90.97	Facility	26	$50.85	$50.86	$90.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.75 / $137.58 / $230.28	Professional		$102.75	$137.58	$230.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.86 / $58.46 / $473.12	Professional	26	$50.86	$58.46	$473.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.89 / $67.45 / $137.71	Professional	TC	$51.89	$67.45	$137.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.55 / $123.95 / $149.88	Professional		$94.55	$123.95	$149.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.49 / $79.61 / $101.78	Professional	26	$45.49	$79.61	$101.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.88 / $160.00 / $350.00	Professional		$115.88	$160.00	$350.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.86 / $130.00 / $175.42	Professional	26	$56.86	$130.00	$175.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.44 / $158.00 / $266.26	Professional	TC	$58.44	$158.00	$266.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.69 / $183.01 / $292.83	Professional		$140.69	$183.01	$292.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.97 / $82.00 / $119.42	Professional	26	$58.97	$82.00	$119.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.41 / $102.78 / $183.00	Professional	TC	$70.41	$102.78	$183.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $102.31 / $108.74 / $180.33	Facility	26	$102.31	$108.74	$180.33
Medcost Facility/Professional Professional Modifier Low / Median / High Price $102.03 / $102.03 / $102.03	Professional		$102.03	$102.03	$102.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $83.61 / $161.31	Professional		$54.90	$83.61	$161.31
United Facility/Professional Professional Modifier Low / Median / High Price $123.84 / $177.15 / $273.89	Professional		$123.84	$177.15	$273.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.03 / $78.13 / $125.11	Professional	26	$57.03	$78.13	$125.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.30 / $89.46 / $162.15	Professional	TC	$62.30	$89.46	$162.15