Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.89 / $248.87 / $494.31	Professional		$178.89	$248.87	$494.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $84.81 / $678.48	Professional	26	$60.63	$84.81	$678.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.24 / $154.54 / $391.01	Professional	TC	$137.24	$154.54	$391.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.12 / $133.25 / $277.61	Professional		$129.12	$133.25	$277.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.19 / $79.95 / $105.92	Professional	26	$37.19	$79.95	$105.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.00 / $163.26 / $259.52	Professional		$147.00	$163.26	$259.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.37 / $163.00 / $211.16	Professional	26	$74.37	$163.00	$211.16
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.12 / $183.86 / $769.82	Professional	TC	$6.12	$183.86	$769.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.80 / $133.63 / $303.38	Professional		$86.80	$133.63	$303.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.07 / $42.08 / $210.00	Professional	26	$37.07	$42.08	$210.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.02 / $90.53 / $216.25	Professional	TC	$44.02	$90.53	$216.25
Medcost Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $239.00 / $315.00	Facility		$160.00	$239.00	$315.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $112.73 / $143.00 / $215.00	Facility	26	$112.73	$143.00	$215.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $165.65 / $205.25 / $331.82	Facility	TC	$165.65	$205.25	$331.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.10 / $179.71 / $326.15	Professional		$88.10	$179.71	$326.15
United Facility/Professional Professional Modifier Low / Median / High Price $130.33 / $177.61 / $417.26	Professional		$130.33	$177.61	$417.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.93 / $58.62 / $173.24	Professional	26	$45.93	$58.62	$173.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.74 / $121.04 / $277.70	Professional	TC	$83.74	$121.04	$277.70