Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.01 / $127.87 / $223.86	Professional		$107.01	$127.87	$223.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $22.73 / $37.28	Professional	26	$11.77	$22.73	$37.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.35 / $103.93 / $189.87	Professional	TC	$95.35	$103.93	$189.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.22 / $127.22 / $174.11	Professional		$127.22	$127.22	$174.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.44 / $22.87 / $38.07	Professional	26	$19.44	$22.87	$38.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $337.36 / $367.26 / $567.75	Facility		$337.36	$367.26	$567.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.34 / $136.99 / $215.14	Professional		$118.34	$136.99	$215.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.27 / $30.00 / $44.30	Professional	26	$21.27	$30.00	$44.30
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.07 / $109.15 / $181.10	Professional	TC	$97.07	$109.15	$181.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $147.68 / $269.52	Facility		$147.68	$147.68	$269.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.00 / $193.34 / $339.28	Professional		$134.00	$193.34	$339.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.69 / $24.74 / $51.32	Professional	26	$12.69	$24.74	$51.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.55 / $174.71 / $320.57	Professional	TC	$121.55	$174.71	$320.57
Medcost Facility/Professional Facility Modifier Low / Median / High Price $109.64 / $159.84 / $255.30	Facility		$109.64	$159.84	$255.30
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.97 / $23.00 / $41.23	Facility	26	$12.97	$23.00	$41.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $155.01 / $224.00 / $338.57	Professional		$155.01	$224.00	$338.57
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $23.00 / $23.00 / $23.00	Professional	26	$23.00	$23.00	$23.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $120.74 / $193.38	Professional		$43.34	$120.74	$193.38
United Facility/Professional Professional Modifier Low / Median / High Price $122.61 / $161.56 / $267.19	Professional		$122.61	$161.56	$267.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $21.81 / $34.19	Professional	26	$11.79	$21.81	$34.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.24 / $142.55 / $231.36	Professional	TC	$106.24	$142.55	$231.36