Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $245.47	Professional		$63.10	$89.13	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $57.54 / $489.78	Professional	26	$25.12	$57.54	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $57.54 / $173.78	Professional	TC	$43.65	$57.54	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $57.54 / $104.71	Professional		$51.29	$57.54	$104.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $35.48 / $37.15	Professional	26	$31.62	$35.48	$37.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	TC	$74.13	$74.13	$74.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $109.65 / $123.03	Professional		$50.12	$109.65	$123.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $33.88 / $56.23	Professional	26	$31.62	$33.88	$56.23
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $70.79 / $75.86	Professional	TC	$16.22	$70.79	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Facility		$43.65	$43.65	$43.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $17.38 / $17.38	Facility	26	$17.38	$17.38	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	TC	$25.70	$25.70	$25.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $50.12 / $123.03	Professional		$42.66	$50.12	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $22.39 / $67.61	Professional	26	$17.78	$22.39	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $69.18	Professional	TC	$19.50	$30.90	$69.18
Medcost Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $100.00 / $169.82	Facility		$72.44	$100.00	$169.82
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 $54.95 / $91.20 / $213.80	Professional		$54.95	$91.20	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $34.67 / $97.72	Professional	26	$20.42	$34.67	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $50.12 / $112.20	Professional	TC	$30.90	$50.12	$112.20