Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.94 / $57.94 / $57.94	Facility	26	$57.94	$57.94	$57.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $100.14 / $175.96	Professional		$75.17	$100.14	$175.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.82 / $57.94 / $92.29	Professional	26	$48.82	$57.94	$92.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $40.72 / $58.65	Professional	TC	$25.10	$40.72	$58.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.06 / $137.21 / $158.29	Professional		$95.06	$137.21	$158.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.94 / $55.42 / $77.27	Professional	26	$47.94	$55.42	$77.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $103.91 / $155.49	Professional		$88.43	$103.91	$155.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.55 / $71.00 / $107.39	Professional	26	$51.55	$71.00	$107.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.00 / $36.07 / $50.89	Professional	TC	$30.00	$36.07	$50.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.71 / $110.85 / $229.02	Professional		$89.71	$110.85	$229.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.22 / $74.75 / $131.85	Professional	26	$61.22	$74.75	$131.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.18 / $34.64 / $95.56	Professional	TC	$25.18	$34.64	$95.56
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $64.09 / $68.95 / $148.69	Facility	26	$64.09	$68.95	$148.69
Medcost Facility/Professional Professional Modifier Low / Median / High Price $71.59 / $71.59 / $71.59	Professional		$71.59	$71.59	$71.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $55.75 / $141.14	Professional		$30.56	$55.75	$141.14
United Facility/Professional Professional Modifier Low / Median / High Price $72.25 / $88.35 / $143.38	Professional		$72.25	$88.35	$143.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.25 / $57.69 / $90.90	Professional	26	$48.25	$57.69	$90.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.07 / $29.98 / $55.61	Professional	TC	$22.07	$29.98	$55.61