Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.73 / $80.73 / $116.12	Facility	26	$80.73	$80.73	$116.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.09 / $148.69 / $333.55	Professional		$127.09	$148.69	$333.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $80.73 / $198.35	Professional	26	$72.04	$80.73	$198.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.25 / $60.89 / $109.29	Professional	TC	$55.25	$60.89	$109.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.79 / $151.60 / $217.09	Professional		$112.79	$151.60	$217.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $78.02 / $78.02 / $103.79	Professional	26	$78.02	$78.02	$103.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $127.34 / $249.72	Professional		$108.00	$127.34	$249.72
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.58 / $88.20 / $149.41	Professional	26	$72.58	$88.20	$149.41
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.00 / $48.70 / $85.58	Professional	TC	$24.00	$48.70	$85.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.55 / $160.06 / $256.70	Professional		$92.55	$160.06	$256.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.09 / $100.76 / $155.33	Professional	26	$82.09	$100.76	$155.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.81 / $74.47 / $114.71	Professional	TC	$60.81	$74.47	$114.71
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $90.54 / $120.08 / $205.56	Facility	26	$90.54	$120.08	$205.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.76 / $112.99 / $183.73	Professional		$63.76	$112.99	$183.73
United Facility/Professional Professional Modifier Low / Median / High Price $130.56 / $152.16 / $252.58	Professional		$130.56	$152.16	$252.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.63 / $90.76 / $140.63	Professional	26	$74.63	$90.76	$140.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.93 / $66.36 / $103.26	Professional	TC	$55.93	$66.36	$103.26