Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.71 / $57.71 / $77.80	Facility	26	$57.71	$57.71	$77.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $319.55 / $429.76 / $1,060.75	Professional		$319.55	$429.76	$1,060.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.15 / $58.03 / $228.00	Professional	26	$51.15	$58.03	$228.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $268.39 / $370.27 / $746.10	Professional	TC	$268.39	$370.27	$746.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $402.33 / $563.26 / $720.17	Professional		$402.33	$563.26	$720.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $78.73 / $93.49	Professional	26	$55.84	$78.73	$93.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $362.82 / $362.82 / $362.82	Professional	TC	$362.82	$362.82	$362.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.00 / $241.91 / $484.16	Professional		$136.00	$241.91	$484.16
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $64.05 / $107.26	Professional	26	$51.94	$64.05	$107.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.00 / $133.40 / $412.93	Professional	TC	$75.00	$133.40	$412.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.18 / $444.67 / $815.85	Professional		$166.18	$444.67	$815.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.85 / $72.23 / $108.94	Professional	26	$56.85	$72.23	$108.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.70 / $397.39 / $703.77	Professional	TC	$104.70	$397.39	$703.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $56.27 / $73.00 / $122.97	Facility	26	$56.27	$73.00	$122.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.74 / $387.38 / $642.08	Professional		$65.74	$387.38	$642.08
United Facility/Professional Professional Modifier Low / Median / High Price $210.79 / $436.63 / $662.07	Professional		$210.79	$436.63	$662.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.83 / $61.34 / $104.53	Professional	26	$50.83	$61.34	$104.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.41 / $381.83 / $605.85	Professional	TC	$167.41	$381.83	$605.85