Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.23 / $12.23 / $24.08	Facility	26	$12.23	$12.23	$24.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.75 / $60.68 / $96.51	Professional		$49.75	$60.68	$96.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $15.71 / $32.31	Professional	26	$12.23	$15.71	$32.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.59 / $44.99 / $73.79	Professional	TC	$34.59	$44.99	$73.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.71 / $13.48 / $24.13	Professional	26	$10.71	$13.48	$24.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.97 / $34.97 / $75.54	Professional	TC	$34.97	$34.97	$75.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.68 / $75.00 / $142.10	Professional		$55.68	$75.00	$142.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.48 / $31.00 / $45.01	Professional	26	$13.48	$31.00	$45.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.20 / $47.62 / $100.34	Professional	TC	$42.20	$47.62	$100.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $74.28 / $131.22	Professional		$54.60	$74.28	$131.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $21.55 / $36.45	Professional	26	$16.61	$21.55	$36.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.09 / $52.84 / $95.50	Professional	TC	$41.09	$52.84	$95.50
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $25.86 / $31.00 / $51.44	Facility	26	$25.86	$31.00	$51.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $221.09 / $221.09 / $221.09	Professional		$221.09	$221.09	$221.09
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $52.26 / $52.26 / $52.26	Professional	26	$52.26	$52.26	$52.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $50.97 / $87.39	Professional		$28.98	$50.97	$87.39
United Facility/Professional Professional Modifier Low / Median / High Price $54.67 / $69.83 / $115.07	Professional		$54.67	$69.83	$115.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $19.75 / $31.08	Professional	26	$14.75	$19.75	$31.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.19 / $51.46 / $83.99	Professional	TC	$39.19	$51.46	$83.99