Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $93.33 / $186.21	Professional		$69.18	$93.33	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $257.04 / $1,023.29	Professional	26	$50.12	$257.04	$1,023.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.11 / $77.62	Professional	TC	$28.18	$33.11	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $102.33	Professional		$46.77	$46.77	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $61.66 / $64.57	Professional	26	$28.18	$61.66	$64.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $100.00 / $128.82	Professional		$75.86	$100.00	$128.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $60.26 / $125.89	Professional	26	$56.23	$60.26	$125.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $4.07 / $36.31 / $38.90	Professional	TC	$4.07	$36.31	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $47.86 / $117.49	Professional		$40.74	$47.86	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $31.62 / $95.50	Professional	26	$28.18	$31.62	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $16.60 / $42.66	Professional	TC	$10.72	$16.60	$42.66
Medcost Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $97.72 / $158.49	Facility		$72.44	$97.72	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $83.18 / $199.53	Professional		$53.70	$83.18	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $54.95 / $138.04	Professional	26	$34.67	$54.95	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $58.88	Professional	TC	$18.20	$25.70	$58.88