Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.70 / $118.58 / $207.40	Professional		$103.70	$118.58	$207.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.02 / $78.91 / $340.00	Professional	26	$52.02	$78.91	$340.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.86 / $66.56 / $123.84	Professional	TC	$61.86	$66.56	$123.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.27 / $155.52 / $167.18	Professional		$76.27	$155.52	$167.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.75 / $68.26 / $90.24	Professional	26	$31.75	$68.26	$90.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $97.65 / $156.30	Professional		$93.00	$97.65	$156.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.50 / $105.00 / $122.41	Professional	26	$63.50	$105.00	$122.41
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2.04 / $92.02 / $368.19	Professional	TC	$2.04	$92.02	$368.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.77 / $74.06 / $189.83	Professional		$60.77	$74.06	$189.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.85 / $36.06 / $154.00	Professional	26	$31.85	$36.06	$154.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.41 / $38.10 / $95.74	Professional	TC	$27.41	$38.10	$95.74
Medcost Facility/Professional Facility Modifier Low / Median / High Price $106.00 / $146.00 / $256.36	Facility		$106.00	$146.00	$256.36
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $65.13 / $95.00 / $130.59	Facility	26	$65.13	$95.00	$130.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.85 / $93.18 / $180.67	Professional		$57.85	$93.18	$180.67
United Facility/Professional Professional Modifier Low / Median / High Price $79.48 / $100.26 / $293.42	Professional		$79.48	$100.26	$293.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.38 / $49.98 / $147.96	Professional	26	$39.38	$49.98	$147.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.50 / $57.18 / $134.06	Professional	TC	$39.50	$57.18	$134.06