Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.11 / $43.11 / $43.11	Facility	26	$43.11	$43.11	$43.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.72 / $80.72 / $143.72	Professional		$63.72	$80.72	$143.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.94 / $43.11 / $66.15	Professional	26	$35.94	$43.11	$66.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.73 / $36.49 / $53.96	Professional	TC	$21.73	$36.49	$53.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.05 / $109.66 / $129.01	Professional		$77.05	$109.66	$129.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $40.88 / $55.14	Professional	26	$35.36	$40.88	$55.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.67 / $84.21 / $127.79	Professional		$71.67	$84.21	$127.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.03 / $56.00 / $81.06	Professional	26	$38.03	$56.00	$81.06
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.00 / $32.65 / $46.42	Professional	TC	$27.00	$32.65	$46.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $87.23 / $185.90	Professional		$70.00	$87.23	$185.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $57.40 / $97.09	Professional	26	$45.71	$57.40	$97.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.72 / $31.01 / $87.46	Professional	TC	$21.72	$31.01	$87.46
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $47.63 / $54.23 / $78.45	Facility	26	$47.63	$54.23	$78.45
Medcost Facility/Professional Professional Modifier Low / Median / High Price $56.07 / $56.07 / $56.07	Professional		$56.07	$56.07	$56.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $53.47 / $99.31	Professional		$30.56	$53.47	$99.31
United Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $70.53 / $140.72	Professional		$57.73	$70.53	$140.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.81 / $44.00 / $72.69	Professional	26	$35.81	$44.00	$72.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $26.38 / $49.29	Professional	TC	$20.30	$26.38	$49.29