Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $11.13 / $11.13	Facility	26	$11.13	$11.13	$11.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.51 / $23.51 / $95.05	Facility	TC	$23.51	$23.51	$95.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.33 / $35.46 / $52.27	Professional		$31.33	$35.46	$52.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $11.80 / $20.18	Professional	26	$10.61	$11.80	$20.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.84 / $23.51 / $34.99	Professional	TC	$20.84	$23.51	$34.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $9.92 / $9.92	Professional	26	$9.80	$9.92	$9.92
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $75.73 / $100.98 / $100.98	Facility	TC	$75.73	$100.98	$100.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $54.00 / $89.99	Professional		$37.90	$54.00	$89.99
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.25 / $28.00 / $40.53	Professional	26	$12.25	$28.00	$40.53
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.66 / $28.84 / $50.00	Professional	TC	$25.66	$28.84	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $48.16 / $87.01	Professional		$38.31	$48.16	$87.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $17.50 / $32.59	Professional	26	$13.93	$17.50	$32.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $31.43 / $57.77	Professional	TC	$23.78	$31.43	$57.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.22 / $23.79 / $40.44	Facility	26	$15.22	$23.79	$40.44
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $34.28 / $34.28 / $64.30	Facility	TC	$34.28	$34.28	$64.30
Medcost Facility/Professional Professional Modifier Low / Median / High Price $151.10 / $151.10 / $151.10	Professional		$151.10	$151.10	$151.10
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $47.25 / $47.25 / $47.25	Professional	26	$47.25	$47.25	$47.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $34.77 / $51.41	Professional		$25.48	$34.77	$51.41
United Facility/Professional Professional Modifier Low / Median / High Price $35.07 / $46.40 / $77.61	Professional		$35.07	$46.40	$77.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.15 / $18.01 / $38.78	Professional	26	$13.15	$18.01	$38.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.80 / $31.79 / $52.07	Professional	TC	$21.80	$31.79	$52.07