Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.56 / $14.56 / $14.56	Facility	26	$14.56	$14.56	$14.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $65.68 / $138.22	Professional		$61.64	$65.68	$138.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $15.61 / $26.57	Professional	26	$13.70	$15.61	$26.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.12 / $49.75 / $64.67	Professional	TC	$44.12	$49.75	$64.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.01 / $122.01 / $128.47	Professional		$122.01	$122.01	$128.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.97 / $12.97 / $12.97	Professional	26	$12.97	$12.97	$12.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $84.82 / $84.82 / $84.82	Professional	TC	$84.82	$84.82	$84.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $83.37 / $153.75	Professional		$71.77	$83.37	$153.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.02 / $32.00 / $46.26	Professional	26	$16.02	$32.00	$46.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $57.98 / $106.37	Professional	TC	$46.00	$57.98	$106.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $88.11 / $166.46	Professional		$65.84	$88.11	$166.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.98 / $22.48 / $40.47	Professional	26	$17.98	$22.48	$40.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.93 / $63.71 / $124.24	Professional	TC	$47.93	$63.71	$124.24
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.12 / $29.28 / $53.72	Facility	26	$26.12	$29.28	$53.72
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $280.67	Professional		$88.83	$88.83	$280.67
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $217.30 / $217.30 / $217.30	Professional	TC	$217.30	$217.30	$217.30
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 $60.26 / $89.84 / $147.88	Professional		$60.26	$89.84	$147.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $22.42 / $37.14	Professional	26	$16.50	$22.42	$37.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.76 / $64.13 / $113.08	Professional	TC	$43.76	$64.13	$113.08