Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.88 / $133.88 / $193.15	Facility	26	$133.88	$133.88	$193.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.03 / $240.87 / $734.00	Professional		$203.03	$240.87	$734.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.34 / $133.88 / $328.97	Professional	26	$120.34	$133.88	$328.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.26 / $88.90 / $161.33	Professional	TC	$81.26	$88.90	$161.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.68 / $266.95 / $341.32	Professional		$190.68	$266.95	$341.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $129.77 / $129.77 / $232.52	Professional	26	$129.77	$129.77	$232.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $202.29 / $395.43	Professional		$171.00	$202.29	$395.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.72 / $148.05 / $250.80	Professional	26	$120.72	$148.05	$250.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.00 / $62.73 / $128.05	Professional	TC	$30.00	$62.73	$128.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.55 / $254.25 / $406.17	Professional		$102.55	$254.25	$406.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.11 / $167.04 / $258.66	Professional	26	$137.11	$167.04	$258.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.33 / $109.46 / $171.02	Professional	TC	$91.33	$109.46	$171.02
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $150.16 / $200.44 / $340.76	Facility	26	$150.16	$200.44	$340.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.76 / $151.88 / $296.64	Professional		$63.76	$151.88	$296.64
United Facility/Professional Professional Modifier Low / Median / High Price $208.33 / $242.02 / $396.18	Professional		$208.33	$242.02	$396.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $118.63 / $141.63 / $234.10	Professional	26	$118.63	$141.63	$234.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.68 / $99.47 / $150.08	Professional	TC	$83.68	$99.47	$150.08