Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.31 / $107.31 / $154.66	Facility	26	$107.31	$107.31	$154.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.36 / $194.54 / $602.00	Professional		$168.36	$194.54	$602.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.29 / $107.31 / $382.81	Professional	26	$96.29	$107.31	$382.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $77.34 / $134.21	Professional	TC	$70.73	$77.34	$134.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.55 / $198.31 / $283.98	Professional		$147.55	$198.31	$283.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $103.92 / $138.24 / $147.24	Professional	26	$103.92	$138.24	$147.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.00 / $166.58 / $328.37	Professional		$142.00	$166.58	$328.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.67 / $118.65 / $201.00	Professional	26	$96.67	$118.65	$201.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $60.63 / $110.45	Professional	TC	$29.00	$60.63	$110.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.55 / $210.57 / $336.11	Professional		$102.55	$210.57	$336.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.70 / $134.83 / $207.33	Professional	26	$109.70	$134.83	$207.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.28 / $94.74 / $148.06	Professional	TC	$78.28	$94.74	$148.06
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $120.35 / $160.22 / $275.07	Facility	26	$120.35	$160.22	$275.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.76 / $116.92 / $211.73	Professional		$63.76	$116.92	$211.73
United Facility/Professional Professional Modifier Low / Median / High Price $172.49 / $207.93 / $330.12	Professional		$172.49	$207.93	$330.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.73 / $121.84 / $198.90	Professional	26	$99.73	$121.84	$198.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.31 / $88.67 / $131.22	Professional	TC	$72.31	$88.67	$131.22