Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.80 / $12.80 / $22.56	Facility	26	$12.80	$12.80	$22.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $63.09 / $160.94	Professional		$56.75	$63.09	$160.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $14.71 / $61.65	Professional	26	$12.80	$14.71	$61.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $45.96 / $83.44	Professional	TC	$42.39	$45.96	$83.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.40 / $95.99 / $112.93	Professional		$69.40	$95.99	$112.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $15.16 / $25.24	Professional	26	$11.44	$15.16	$25.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.30 / $58.30 / $68.59	Professional	TC	$58.30	$58.30	$68.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.09 / $75.92 / $136.66	Professional		$63.09	$75.92	$136.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.10 / $30.00 / $42.50	Professional	26	$14.10	$30.00	$42.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.00 / $51.44 / $87.82	Professional	TC	$42.00	$51.44	$87.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.73 / $76.12 / $141.59	Professional		$58.73	$76.12	$141.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $20.60 / $37.47	Professional	26	$16.22	$20.60	$37.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.99 / $58.68 / $110.12	Professional	TC	$43.99	$58.68	$110.12
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.97 / $25.74 / $47.94	Facility	26	$23.97	$25.74	$47.94
Medcost Facility/Professional Professional Modifier Low / Median / High Price $250.61 / $250.61 / $250.61	Professional		$250.61	$250.61	$250.61
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $194.86 / $194.86 / $194.86	Professional	TC	$194.86	$194.86	$194.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.97 / $69.55 / $102.82	Professional		$50.97	$69.55	$102.82
United Facility/Professional Professional Modifier Low / Median / High Price $55.43 / $78.66 / $130.28	Professional		$55.43	$78.66	$130.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.97 / $19.86 / $31.54	Professional	26	$14.97	$19.86	$31.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.31 / $57.92 / $97.58	Professional	TC	$40.31	$57.92	$97.58