Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.08 / $13.09 / $23.07	Facility	26	$13.08	$13.09	$23.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $47.68 / $92.99	Professional		$42.24	$47.68	$92.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $13.58 / $25.64	Professional	26	$13.09	$13.58	$25.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.03 / $34.09 / $55.90	Professional	TC	$29.03	$34.09	$55.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $15.50 / $25.81	Professional	26	$11.50	$15.50	$25.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.17 / $62.00 / $110.71	Professional		$47.17	$62.00	$110.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.42 / $33.00 / $49.41	Professional	26	$14.42	$33.00	$49.41
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $34.74 / $65.70	Professional	TC	$29.00	$34.74	$65.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.04 / $62.00 / $108.01	Professional		$47.04	$62.00	$108.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $20.74 / $36.07	Professional	26	$14.76	$20.74	$36.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $41.91 / $71.95	Professional	TC	$32.40	$41.91	$71.95
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $22.68 / $27.00 / $47.76	Facility	26	$22.68	$27.00	$47.76
Medcost Facility/Professional Professional Modifier Low / Median / High Price $188.20 / $188.20 / $188.20	Professional		$188.20	$188.20	$188.20
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $132.22 / $132.22 / $132.22	Professional	TC	$132.22	$132.22	$132.22
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 $44.78 / $60.01 / $99.59	Professional		$44.78	$60.01	$99.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.69 / $19.92 / $31.57	Professional	26	$14.69	$19.92	$31.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.09 / $40.76 / $66.34	Professional	TC	$30.09	$40.76	$66.34