Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.98 / $209.52 / $375.94	Professional		$117.98	$209.52	$375.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.47 / $36.95 / $169.15	Professional	26	$28.47	$36.95	$169.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $100.17 / $633.76	Professional	TC	$68.95	$100.17	$633.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.37 / $77.39 / $154.79	Professional		$75.37	$77.39	$154.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.61 / $37.85 / $40.49	Professional	26	$17.61	$37.85	$40.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.00 / $95.55 / $158.12	Professional		$91.00	$95.55	$158.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.21 / $62.00 / $72.43	Professional	26	$35.21	$62.00	$72.43
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $30.45 / $120.17	Professional	TC	$29.00	$30.45	$120.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $78.23 / $185.25	Professional		$55.32	$78.23	$185.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.44 / $20.56 / $58.31	Professional	26	$19.44	$20.56	$58.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.74 / $59.97 / $146.40	Professional	TC	$35.74	$59.97	$146.40
Medcost Facility/Professional Facility Modifier Low / Median / High Price $129.93 / $163.37 / $196.04	Facility		$129.93	$163.37	$196.04
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $51.10 / $58.66 / $58.66	Facility	26	$51.10	$58.66	$58.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $129.94 / $201.84	Professional		$45.28	$129.94	$201.84
United Facility/Professional Professional Modifier Low / Median / High Price $65.48 / $105.24 / $272.39	Professional		$65.48	$105.24	$272.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.40 / $28.04 / $80.12	Professional	26	$22.40	$28.04	$80.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.05 / $81.48 / $189.48	Professional	TC	$42.05	$81.48	$189.48