Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.25 / $6.25 / $8.61	Facility	26	$6.25	$6.25	$8.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $11.47 / $11.47 / $46.37	Facility	TC	$11.47	$11.47	$46.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $21.55 / $42.84	Professional		$17.30	$21.55	$42.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $6.66 / $15.09	Professional	26	$6.25	$6.66	$15.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.11 / $39.11 / $39.11	Professional	50	$39.11	$39.11	$39.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.31 / $14.78 / $24.51	Professional	TC	$11.31	$14.78	$24.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.73 / $35.01 / $35.01	Professional		$15.73	$35.01	$35.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.59 / $6.89 / $12.33	Professional	26	$5.59	$6.89	$12.33
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $44.64 / $44.64 / $44.64	Professional	50	$44.64	$44.64	$44.64
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $34.02 / $34.02	Professional	TC	$34.02	$34.02	$34.02
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $48.42 / $64.56 / $64.56	Facility	TC	$48.42	$64.56	$64.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.55 / $31.00 / $53.75	Professional		$19.55	$31.00	$53.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $17.50 / $23.33	Professional	26	$6.89	$17.50	$23.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.67 / $14.60 / $28.23	Professional	TC	$12.67	$14.60	$28.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.61 / $28.54 / $46.08	Professional		$19.61	$28.54	$46.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.05 / $10.00 / $17.11	Professional	26	$7.05	$10.00	$17.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.91 / $19.20 / $31.44	Professional	TC	$14.91	$19.20	$31.44
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.74 / $13.00 / $22.72	Facility	26	$10.74	$13.00	$22.72
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $20.34 / $26.42 / $41.91	Facility	TC	$20.34	$26.42	$41.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $76.73 / $76.73	Professional		$76.73	$76.73	$76.73
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $27.23 / $27.23	Professional	26	$27.23	$27.23	$27.23
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $115.09 / $115.09 / $115.09	Professional	50	$115.09	$115.09	$115.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $25.43 / $25.43	Professional		$25.43	$25.43	$25.43
United Facility/Professional Professional Modifier Low / Median / High Price $19.94 / $28.15 / $41.27	Professional		$19.94	$28.15	$41.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $9.50 / $15.77	Professional	26	$6.91	$9.50	$15.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.02 / $17.82 / $26.06	Professional	TC	$13.02	$17.82	$26.06