Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.03 / $122.03 / $226.75	Facility	26	$122.03	$122.03	$226.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $555.67 / $696.77 / $1,239.63	Professional		$555.67	$696.77	$1,239.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.86 / $131.91 / $633.97	Professional	26	$103.86	$131.91	$633.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $247.60 / $301.77 / $379.13	Professional	52	$247.60	$301.77	$379.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $434.27 / $559.03 / $960.19	Professional	TC	$434.27	$559.03	$960.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $579.34 / $786.51 / $786.51	Professional		$579.34	$786.51	$786.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $117.45 / $120.19 / $195.58	Professional	26	$117.45	$120.19	$195.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $561.79 / $648.86 / $1,065.52	Professional		$561.79	$648.86	$1,065.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.26 / $273.00 / $387.84	Professional	26	$109.26	$273.00	$387.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $300.00 / $452.53 / $679.26	Professional	TC	$300.00	$452.53	$679.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $628.80 / $815.25 / $1,205.78	Professional		$628.80	$815.25	$1,205.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.27 / $186.60 / $250.22	Professional	26	$129.27	$186.60	$250.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $501.27 / $643.91 / $965.08	Professional	TC	$501.27	$643.91	$965.08
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $158.43 / $209.83 / $290.00	Facility	26	$158.43	$209.83	$290.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $133.98 / $515.56 / $869.46	Professional		$133.98	$515.56	$869.46
United Facility/Professional Professional Modifier Low / Median / High Price $562.30 / $683.63 / $1,048.96	Professional		$562.30	$683.63	$1,048.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.34 / $143.19 / $235.44	Professional	26	$112.34	$143.19	$235.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $439.40 / $561.89 / $925.98	Professional	TC	$439.40	$561.89	$925.98