Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.88 / $62.88 / $89.53	Facility	26	$62.88	$62.88	$89.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $107.53 / $181.15	Professional		$90.76	$107.53	$181.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.44 / $62.88 / $99.54	Professional	26	$53.44	$62.88	$99.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $45.10 / $62.56	Professional	TC	$28.48	$45.10	$62.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.12 / $170.95 / $171.90	Professional		$146.12	$170.95	$171.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.16 / $61.56 / $95.13	Professional	26	$60.16	$61.56	$95.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $119.00 / $183.20	Professional		$95.50	$119.00	$183.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.96 / $85.00 / $123.05	Professional	26	$55.96	$85.00	$123.05
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.00 / $39.54 / $54.57	Professional	TC	$34.00	$39.54	$54.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.69 / $124.87 / $247.22	Professional		$99.69	$124.87	$247.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.40 / $85.29 / $143.21	Professional	26	$67.40	$85.29	$143.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.78 / $37.90 / $102.18	Professional	TC	$28.78	$37.90	$102.18
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $70.52 / $81.14 / $115.94	Facility	26	$70.52	$81.14	$115.94
Medcost Facility/Professional Professional Modifier Low / Median / High Price $80.77 / $80.77 / $80.77	Professional		$80.77	$80.77	$80.77
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 $76.13 / $95.56 / $152.10	Professional		$76.13	$95.56	$152.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.97 / $64.92 / $107.99	Professional	26	$51.97	$64.92	$107.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.84 / $31.71 / $59.73	Professional	TC	$24.84	$31.71	$59.73