Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.31 / $57.31 / $100.49	Facility	26	$57.31	$57.31	$100.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.95 / $399.26 / $580.78	Professional		$361.95	$399.26	$580.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.31 / $62.81 / $138.34	Professional	26	$57.31	$62.81	$138.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $304.64 / $338.29 / $508.02	Professional	TC	$304.64	$338.29	$508.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $330.00 / $330.00 / $330.00	Professional		$330.00	$330.00	$330.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.77 / $67.52 / $112.43	Professional	26	$50.77	$67.52	$112.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.00 / $397.52 / $529.33	Professional		$374.00	$397.52	$529.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.81 / $100.00 / $186.00	Professional	26	$62.81	$100.00	$186.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $240.00 / $317.61 / $449.00	Professional	TC	$240.00	$317.61	$449.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $485.47 / $578.99 / $1,094.58	Professional		$485.47	$578.99	$1,094.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.48 / $88.85 / $173.32	Professional	26	$74.48	$88.85	$173.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $410.99 / $490.14 / $921.26	Professional	TC	$410.99	$490.14	$921.26
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $78.70 / $106.74 / $197.62	Facility	26	$78.70	$106.74	$197.62
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,066.15 / $1,066.15 / $1,066.15	Professional		$1,066.15	$1,066.15	$1,066.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.02 / $361.82 / $490.26	Professional		$41.02	$361.82	$490.26
United Facility/Professional Professional Modifier Low / Median / High Price $444.46 / $624.04 / $809.27	Professional		$444.46	$624.04	$809.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.26 / $88.95 / $134.37	Professional	26	$66.26	$88.95	$134.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $376.57 / $471.92 / $745.29	Professional	TC	$376.57	$471.92	$745.29