Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.92 / $46.93 / $67.42	Facility	26	$46.92	$46.93	$67.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $261.73 / $406.85	Professional		$206.63	$261.73	$406.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.69 / $49.28 / $92.11	Professional	26	$42.69	$49.28	$92.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $216.30 / $335.27	Professional	TC	$162.49	$216.30	$335.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $45.13 / $45.13	Professional	26	$34.04	$45.13	$45.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.12 / $275.72 / $444.85	Professional		$229.12	$275.72	$444.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.98 / $80.00 / $122.38	Professional	26	$41.98	$80.00	$122.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.00 / $198.95 / $307.72	Professional	TC	$173.00	$198.95	$307.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.37 / $345.99 / $538.62	Professional		$262.37	$345.99	$538.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.84 / $56.48 / $91.14	Professional	26	$44.84	$56.48	$91.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.18 / $288.70 / $459.13	Professional	TC	$218.18	$288.70	$459.13
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $48.77 / $85.00 / $120.44	Facility	26	$48.77	$85.00	$120.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $963.17 / $963.17 / $963.17	Professional		$963.17	$963.17	$963.17
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $167.18 / $167.18 / $167.18	Professional	26	$167.18	$167.18	$167.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $239.07 / $374.73	Professional		$44.14	$239.07	$374.73
United Facility/Professional Professional Modifier Low / Median / High Price $241.76 / $295.02 / $504.70	Professional		$241.76	$295.02	$504.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.42 / $49.45 / $84.92	Professional	26	$41.42	$49.45	$84.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.37 / $249.18 / $419.38	Professional	TC	$199.37	$249.18	$419.38