Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $275.42	Professional		$102.33	$134.90	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $22.91 / $51.29	Professional	26	$13.18	$22.91	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $112.20 / $181.97	Professional	TC	$95.50	$112.20	$181.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $223.87	Professional		$114.82	$147.91	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.99 / $39.81	Professional	26	$17.38	$23.99	$39.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $173.78 / $173.78	Professional	TC	$173.78	$173.78	$173.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $616.60	Facility		$371.54	$371.54	$616.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $138.04 / $213.80	Professional		$120.23	$138.04	$213.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $29.51 / $42.66	Professional	26	$22.39	$29.51	$42.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $109.65 / $181.97	Professional	TC	$97.72	$109.65	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $309.03	Facility		$204.17	$204.17	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	26	$5.62	$26.30	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $199.53 / $398.11	Professional		$134.90	$199.53	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $25.70 / $58.88	Professional	26	$13.49	$25.70	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $177.83 / $346.74	Professional	TC	$123.03	$177.83	$346.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $223.87	Professional		$218.78	$218.78	$223.87
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $19.95 / $20.89	Professional	26	$19.95	$19.95	$20.89
Medcost Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $177.83 / $331.13	Facility		$123.03	$177.83	$331.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $169.82 / $275.42	Professional		$125.89	$169.82	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $21.88 / $33.88	Professional	26	$11.75	$21.88	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $147.91 / $251.19	Professional	TC	$107.15	$147.91	$251.19