Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.66 / $5.66 / $9.98	Facility	26	$5.66	$5.66	$9.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $44.83 / $432.75	Facility	TC	$25.12	$44.83	$432.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $36.15 / $93.62	Professional		$23.62	$36.15	$93.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.66 / $8.10 / $36.52	Professional	26	$5.66	$8.10	$36.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $68.54 / $95.40 / $109.66	Professional	50	$68.54	$95.40	$109.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.22 / $15.39 / $17.02	Professional	52	$12.22	$15.39	$17.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $26.56 / $53.99	Professional	TC	$22.57	$26.56	$53.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $49.52 / $61.34	Professional		$29.13	$49.52	$61.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.97 / $6.84 / $11.17	Professional	26	$4.97	$6.84	$11.17
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $78.20 / $92.01 / $92.01	Professional	50	$78.20	$92.01	$92.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $30.82 / $42.63	Professional	TC	$23.23	$30.82	$42.63
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $47.68 / $63.57 / $408.90	Facility	TC	$47.68	$63.57	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $36.14 / $53.41	Professional		$28.00	$36.14	$53.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.24 / $15.00 / $20.58	Professional	26	$6.24	$15.00	$20.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.00 / $27.72 / $38.49	Professional	TC	$13.00	$27.72	$38.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $36.58 / $74.17	Professional		$24.18	$36.58	$74.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $9.00 / $16.57	Professional	26	$6.09	$9.00	$16.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.46 / $28.62 / $58.69	Professional	TC	$18.46	$28.62	$58.69
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $9.69 / $11.00 / $19.77	Facility	26	$9.69	$11.00	$19.77
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $27.57 / $52.16 / $79.03	Facility	TC	$27.57	$52.16	$79.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $133.29 / $133.29 / $133.29	Professional		$133.29	$133.29	$133.29
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $199.93 / $199.93 / $199.93	Professional	50	$199.93	$199.93	$199.93
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $108.60 / $108.60 / $108.60	Professional	TC	$108.60	$108.60	$108.60
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 $24.94 / $36.36 / $68.39	Professional		$24.94	$36.36	$68.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.20 / $8.26 / $14.27	Professional	26	$6.20	$8.26	$14.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $28.87 / $54.12	Professional	TC	$18.98	$28.87	$54.12