Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.66 / $24.66 / $24.66	Facility	26	$24.66	$24.66	$24.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.53 / $170.08 / $264.31	Professional		$120.53	$170.08	$264.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $24.66 / $43.09	Professional	26	$18.76	$24.66	$43.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.87 / $123.40 / $204.06	Professional	TC	$97.87	$123.40	$204.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $38.72 / $38.72	Professional	26	$23.25	$38.72	$38.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.87 / $149.10 / $270.67	Professional		$109.87	$149.10	$270.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $28.35 / $45.87	Professional	26	$21.63	$28.35	$45.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.24 / $120.35 / $208.61	Professional	TC	$88.24	$120.35	$208.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.19 / $165.39 / $253.78	Professional		$126.19	$165.39	$253.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.71 / $26.64 / $46.55	Professional	26	$20.71	$26.64	$46.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.90 / $137.84 / $210.61	Professional	TC	$101.90	$137.84	$210.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $22.58 / $36.00 / $54.92	Facility	26	$22.58	$36.00	$54.92
Medcost Facility/Professional Professional Modifier Low / Median / High Price $448.74 / $448.74 / $448.74	Professional		$448.74	$448.74	$448.74
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $360.16 / $360.16 / $360.16	Professional	TC	$360.16	$360.16	$360.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $120.74 / $186.97	Professional		$44.14	$120.74	$186.97
United Facility/Professional Professional Modifier Low / Median / High Price $114.29 / $154.50 / $255.72	Professional		$114.29	$154.50	$255.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.26 / $24.92 / $43.51	Professional	26	$19.26	$24.92	$43.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.28 / $131.62 / $225.35	Professional	TC	$93.28	$131.62	$225.35