Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.80 / $6.81 / $12.01	Facility	26	$6.80	$6.81	$12.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.92 / $33.25 / $101.70	Professional		$20.92	$33.25	$101.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $8.26 / $45.90	Professional	26	$6.81	$8.26	$45.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $108.00 / $125.26 / $452.40	Professional	50	$108.00	$125.26	$452.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $20.78 / $39.00	Professional	TC	$18.82	$20.78	$39.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.19 / $34.90 / $52.50	Professional		$24.19	$34.90	$52.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.01 / $8.07 / $13.44	Professional	26	$6.01	$8.07	$13.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $47.29 / $47.29 / $47.29	Professional	50	$47.29	$47.29	$47.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.00 / $24.00 / $30.55	Professional	TC	$24.00	$24.00	$30.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.33 / $35.70 / $61.22	Professional		$29.33	$35.70	$61.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $19.00 / $24.91	Professional	26	$7.51	$19.00	$24.91
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $21.82 / $34.69	Professional	TC	$15.00	$21.82	$34.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.03 / $36.11 / $65.56	Professional		$26.03	$36.11	$65.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $10.81 / $18.64	Professional	26	$7.50	$10.81	$18.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.66 / $25.07 / $46.91	Professional	TC	$18.66	$25.07	$46.91
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.11 / $14.00 / $24.00	Facility	26	$12.11	$14.00	$24.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $114.63 / $114.63 / $114.63	Professional		$114.63	$114.63	$114.63
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $171.95 / $171.95 / $171.95	Professional	50	$171.95	$171.95	$171.95
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $84.93 / $84.93 / $84.93	Professional	TC	$84.93	$84.93	$84.93
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 $23.57 / $34.36 / $60.34	Professional		$23.57	$34.36	$60.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $10.37 / $16.11	Professional	26	$7.58	$10.37	$16.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.69 / $25.02 / $43.25	Professional	TC	$16.69	$25.02	$43.25