Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.27 / $47.27 / $82.89	Facility	26	$47.27	$47.27	$82.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.12 / $162.22 / $294.27	Professional		$142.12	$162.22	$294.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.27 / $51.54 / $93.15	Professional	26	$47.27	$51.54	$93.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.85 / $101.57 / $173.24	Professional	TC	$94.85	$101.57	$173.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.67 / $170.67 / $170.67	Professional		$170.67	$170.67	$170.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.30 / $52.27 / $56.19	Professional	26	$42.30	$52.27	$56.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.76 / $291.00 / $381.59	Professional		$158.76	$291.00	$381.59
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.27 / $74.00 / $101.29	Professional	26	$52.27	$74.00	$101.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.49 / $126.11 / $214.91	Professional	TC	$106.49	$126.11	$214.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.51 / $244.23 / $401.65	Professional		$181.51	$244.23	$401.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $77.81 / $121.22	Professional	26	$55.93	$77.81	$121.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.14 / $162.80 / $277.80	Professional	TC	$119.14	$162.80	$277.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $86.15 / $102.00 / $180.39	Facility	26	$86.15	$102.00	$180.39
Medcost Facility/Professional Professional Modifier Low / Median / High Price $399.25 / $399.25 / $399.25	Professional		$399.25	$399.25	$399.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.02 / $142.97 / $196.89	Professional		$41.02	$142.97	$196.89
United Facility/Professional Professional Modifier Low / Median / High Price $163.94 / $210.84 / $349.90	Professional		$163.94	$210.84	$349.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.41 / $70.03 / $120.78	Professional	26	$53.41	$70.03	$120.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.89 / $138.06 / $225.48	Professional	TC	$109.89	$138.06	$225.48