Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $11.13 / $11.13	Facility	26	$11.13	$11.13	$11.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $49.98 / $109.49	Professional		$42.84	$49.98	$109.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.13 / $12.78 / $20.39	Professional	26	$11.13	$12.78	$20.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $37.15 / $67.04	Professional	TC	$34.14	$37.15	$67.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.41 / $97.41 / $97.41	Professional		$97.41	$97.41	$97.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.39 / $22.39	Professional	26	$22.39	$22.39	$22.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.42 / $105.00 / $185.86	Professional		$54.42	$105.00	$185.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.51 / $64.16 / $84.40	Professional	26	$12.51	$64.16	$84.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.00 / $44.45 / $108.00	Professional	TC	$40.00	$44.45	$108.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.55 / $63.07 / $117.21	Professional		$48.55	$63.07	$117.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $17.94 / $32.59	Professional	26	$14.32	$17.94	$32.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.58 / $47.44 / $89.18	Professional	TC	$35.58	$47.44	$89.18
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $18.14 / $21.32 / $42.63	Facility	26	$18.14	$21.32	$42.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $210.20 / $210.20 / $210.20	Professional		$210.20	$210.20	$210.20
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $315.30 / $315.30 / $315.30	Professional	50	$315.30	$315.30	$315.30
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $161.77 / $161.77 / $161.77	Professional	TC	$161.77	$161.77	$161.77
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 $45.89 / $65.11 / $108.06	Professional		$45.89	$65.11	$108.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.28 / $17.14 / $26.99	Professional	26	$13.28	$17.14	$26.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $47.45 / $79.91	Professional	TC	$32.47	$47.45	$79.91