Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.25 / $66.25 / $66.25	Facility		$66.25	$66.25	$66.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.89 / $18.89 / $18.89	Facility	26	$18.89	$18.89	$18.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.39 / $74.44 / $169.56	Professional		$62.39	$74.44	$169.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.90 / $18.18 / $23.82	Professional	26	$15.90	$18.18	$23.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.92 / $51.98 / $145.75	Professional	TC	$44.92	$51.98	$145.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.17 / $24.17 / $24.17	Professional	26	$24.17	$24.17	$24.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.19 / $647.79 / $1,088.33	Facility		$302.19	$647.79	$1,088.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.50 / $66.90 / $128.34	Professional		$55.50	$66.90	$128.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $30.57 / $61.09	Professional	26	$16.89	$30.57	$61.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.00 / $42.50 / $93.47	Professional	TC	$12.00	$42.50	$93.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.20 / $275.20 / $275.20	Facility		$275.20	$275.20	$275.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $105.79 / $173.79	Professional		$65.00	$105.79	$173.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.59 / $23.26 / $36.47	Professional	26	$18.59	$23.26	$36.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.47 / $85.46 / $146.13	Professional	TC	$50.47	$85.46	$146.13
Medcost Facility/Professional Facility Modifier Low / Median / High Price $62.00 / $86.13 / $156.78	Facility		$62.00	$86.13	$156.78
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $18.52 / $24.00 / $39.89	Facility	26	$18.52	$24.00	$39.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.95 / $55.22 / $94.29	Professional		$29.95	$55.22	$94.29
United Facility/Professional Professional Modifier Low / Median / High Price $61.13 / $92.12 / $180.69	Professional		$61.13	$92.12	$180.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.86 / $19.71 / $33.15	Professional	26	$16.86	$19.71	$33.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.09 / $66.14 / $132.86	Professional	TC	$44.09	$66.14	$132.86