Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.81 / $25.81 / $25.81	Facility	26	$25.81	$25.81	$25.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $128.19 / $155.72	Professional		$95.27	$128.19	$155.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $30.91 / $50.66	Professional	26	$23.50	$30.91	$50.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.98 / $100.25 / $123.72	Professional	TC	$65.98	$100.25	$123.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.72 / $35.72 / $59.48	Professional	26	$35.72	$35.72	$59.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.33 / $172.42 / $297.14	Professional		$130.33	$172.42	$297.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $53.15 / $75.54	Professional	26	$33.22	$53.15	$75.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.10 / $120.11 / $201.00	Professional	TC	$97.10	$120.11	$201.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.11 / $213.40 / $322.99	Professional		$155.11	$213.40	$322.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.93 / $36.56 / $51.78	Professional	26	$26.93	$36.56	$51.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.59 / $179.73 / $271.32	Professional	TC	$128.59	$179.73	$271.32
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $32.44 / $53.75 / $66.61	Facility	26	$32.44	$53.75	$66.61
Medcost Facility/Professional Professional Modifier Low / Median / High Price $471.74 / $471.74 / $471.74	Professional		$471.74	$471.74	$471.74
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $380.25 / $380.25 / $380.25	Professional	TC	$380.25	$380.25	$380.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $130.87 / $227.07	Professional		$44.14	$130.87	$227.07
United Facility/Professional Professional Modifier Low / Median / High Price $144.12 / $189.80 / $311.67	Professional		$144.12	$189.80	$311.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.56 / $30.91 / $50.02	Professional	26	$23.56	$30.91	$50.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.56 / $160.25 / $264.27	Professional	TC	$120.56	$160.25	$264.27