Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.40 / $82.40 / $82.40	Facility	26	$82.40	$82.40	$82.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $683.19 / $756.17 / $1,099.28	Professional		$683.19	$756.17	$1,099.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.40 / $87.40 / $177.11	Professional	26	$82.40	$87.40	$177.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $600.79 / $668.77 / $996.01	Professional	TC	$600.79	$668.77	$996.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $468.00 / $468.00 / $468.00	Professional		$468.00	$468.00	$468.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $96.94 / $96.94 / $96.94	Professional	26	$96.94	$96.94	$96.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $702.00 / $746.16 / $994.32	Professional		$702.00	$746.16	$994.32
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.18 / $142.00 / $264.00	Professional	26	$90.18	$142.00	$264.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $488.00 / $624.83 / $880.17	Professional	TC	$488.00	$624.83	$880.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $911.53 / $1,087.10 / $2,066.07	Professional		$911.53	$1,087.10	$2,066.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.80 / $126.20 / $249.18	Professional	26	$105.80	$126.20	$249.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $805.73 / $960.91 / $1,816.89	Professional	TC	$805.73	$960.91	$1,816.89
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $113.16 / $151.68 / $301.27	Facility	26	$113.16	$151.68	$301.27
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,207.52 / $1,207.52 / $1,207.52	Professional		$1,207.52	$1,207.52	$1,207.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.64 / $631.19 / $934.96	Professional		$94.64	$631.19	$934.96
United Facility/Professional Professional Modifier Low / Median / High Price $834.69 / $1,051.22 / $1,651.99	Professional		$834.69	$1,051.22	$1,651.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.20 / $130.96 / $190.87	Professional	26	$94.20	$130.96	$190.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $738.25 / $963.66 / $1,395.07	Professional	TC	$738.25	$963.66	$1,395.07