Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.19 / $140.00 / $230.00	Professional		$92.19	$140.00	$230.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $32.77 / $59.50	Professional	26	$17.05	$32.77	$59.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.49 / $83.72 / $206.54	Professional	TC	$51.49	$83.72	$206.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.42 / $71.42 / $71.42	Professional		$71.42	$71.42	$71.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $35.22 / $35.22	Professional	26	$35.22	$35.22	$35.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $72.45 / $130.51	Professional		$69.00	$72.45	$130.51
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $26.25 / $67.33	Professional	26	$25.00	$26.25	$67.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.52 / $44.00 / $97.59	Professional	TC	$26.52	$44.00	$97.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.36 / $60.62 / $191.65	Professional		$44.36	$60.62	$191.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.04 / $21.03 / $67.94	Professional	26	$18.04	$21.03	$67.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $33.79 / $120.43	Professional	TC	$21.45	$33.79	$120.43
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $54.90 / $71.00 / $77.00	Facility	26	$54.90	$71.00	$77.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $124.60 / $191.85	Professional		$45.28	$124.60	$191.85
United Facility/Professional Professional Modifier Low / Median / High Price $54.77 / $89.94 / $201.63	Professional		$54.77	$89.94	$201.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $24.23 / $75.06	Professional	26	$20.78	$24.23	$75.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.58 / $63.05 / $136.41	Professional	TC	$30.58	$63.05	$136.41