Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $11.98 / $14.97	Facility	26	$11.98	$11.98	$14.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.81 / $39.76 / $382.06	Facility	TC	$31.81	$39.76	$382.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.91 / $47.17 / $105.71	Professional		$42.91	$47.17	$105.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.98 / $13.41 / $32.97	Professional	26	$11.98	$13.41	$32.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.00 / $75.00 / $486.16	Professional	50	$75.00	$75.00	$486.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $32.34 / $75.20	Professional	TC	$30.85	$32.34	$75.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.02 / $73.94 / $86.99	Professional		$40.02	$73.94	$86.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $13.19 / $23.61	Professional	26	$10.55	$13.19	$23.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $63.38 / $63.38	Professional	TC	$29.34	$63.38	$63.38
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $140.00 / $186.66 / $186.66	Facility	TC	$140.00	$186.66	$186.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $62.42 / $105.26	Professional		$48.60	$62.42	$105.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $29.00 / $40.01	Professional	26	$13.19	$29.00	$40.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.00 / $37.20 / $64.81	Professional	TC	$31.00	$37.20	$64.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.47 / $60.99 / $114.66	Professional		$47.47	$60.99	$114.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $19.26 / $35.10	Professional	26	$15.37	$19.26	$35.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.00 / $42.69 / $78.70	Professional	TC	$32.00	$42.69	$78.70
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $19.13 / $33.26 / $51.77	Facility	26	$19.13	$33.26	$51.77
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $45.93 / $45.93 / $94.46	Facility	TC	$45.93	$45.93	$94.46
Medcost Facility/Professional Professional Modifier Low / Median / High Price $191.47 / $191.47 / $191.47	Professional		$191.47	$191.47	$191.47
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $287.20 / $287.20 / $287.20	Professional	50	$287.20	$287.20	$287.20
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $139.32 / $139.32 / $139.32	Professional	TC	$139.32	$139.32	$139.32
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 $43.44 / $60.70 / $100.02	Professional		$43.44	$60.70	$100.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.97 / $18.19 / $30.33	Professional	26	$13.97	$18.19	$30.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.33 / $42.42 / $70.41	Professional	TC	$29.33	$42.42	$70.41