Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.48 / $100.48 / $343.62	Professional		$75.48	$100.48	$343.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.30 / $135.15 / $755.41	Professional	26	$48.30	$135.15	$755.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.42 / $32.26 / $68.23	Professional	TC	$28.42	$32.26	$68.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $45.50 / $46.22	Professional		$45.50	$45.50	$46.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $60.67 / $80.33	Professional	26	$28.22	$60.67	$80.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.44 / $109.00 / $129.55	Professional		$92.44	$109.00	$129.55
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.44 / $100.00 / $125.47	Professional	26	$56.44	$100.00	$125.47
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $4.08 / $9.00 / $36.18	Professional	TC	$4.08	$9.00	$36.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.49 / $48.06 / $125.59	Professional		$40.49	$48.06	$125.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.85 / $31.57 / $139.30	Professional	26	$27.85	$31.57	$139.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.83 / $16.77 / $44.11	Professional	TC	$10.83	$16.77	$44.11
Medcost Facility/Professional Facility Modifier Low / Median / High Price $82.78 / $125.47 / $169.00	Facility		$82.78	$125.47	$169.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $85.32 / $107.00 / $132.00	Facility	26	$85.32	$107.00	$132.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $39.01 / $42.70 / $69.14	Facility	TC	$39.01	$42.70	$69.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $62.29 / $111.83	Professional		$28.00	$62.29	$111.83
United Facility/Professional Professional Modifier Low / Median / High Price $53.18 / $83.09 / $192.84	Professional		$53.18	$83.09	$192.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $44.25 / $137.76	Professional	26	$34.67	$44.25	$137.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.48 / $22.59 / $53.83	Professional	TC	$15.48	$22.59	$53.83