Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.50 / $12.50 / $22.04	Facility	26	$12.50	$12.50	$22.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.46 / $67.39 / $129.65	Professional		$50.46	$67.39	$129.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.50 / $16.17 / $24.73	Professional	26	$12.50	$16.17	$24.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.96 / $51.21 / $87.82	Professional	TC	$37.96	$51.21	$87.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $59.22 / $96.41	Professional		$45.41	$59.22	$96.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.02 / $14.81 / $24.67	Professional	26	$11.02	$14.81	$24.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.41 / $44.41 / $45.44	Professional	TC	$44.41	$44.41	$45.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $78.00 / $163.09	Professional		$55.09	$78.00	$163.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.78 / $32.00 / $46.26	Professional	26	$13.78	$32.00	$46.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.31 / $49.71 / $118.00	Professional	TC	$41.31	$49.71	$118.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.47 / $78.00 / $132.44	Professional		$58.47	$78.00	$132.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $20.98 / $36.90	Professional	26	$16.61	$20.98	$36.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.65 / $55.58 / $95.53	Professional	TC	$41.65	$55.58	$95.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.10 / $31.00 / $47.23	Facility	26	$26.10	$31.00	$47.23
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 $53.43 / $53.43 / $53.43	Professional	26	$53.43	$53.43	$53.43
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 $55.47 / $71.87 / $115.07	Professional		$55.47	$71.87	$115.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $18.73 / $30.51	Professional	26	$14.75	$18.73	$30.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.49 / $53.21 / $85.64	Professional	TC	$40.49	$53.21	$85.64