Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.80 / $12.80 / $12.80	Facility	26	$12.80	$12.80	$12.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.33 / $52.32 / $111.41	Professional		$49.33	$52.32	$111.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $14.36 / $34.86	Professional	26	$12.80	$14.36	$34.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.09 / $37.70 / $59.08	Professional	TC	$33.09	$37.70	$59.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $61.28 / $99.72	Professional		$45.92	$61.28	$99.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $14.10 / $25.24	Professional	26	$11.44	$14.10	$25.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.77 / $45.77 / $45.77	Professional	TC	$45.77	$45.77	$45.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.71 / $71.79 / $122.50	Professional		$55.71	$71.79	$122.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.10 / $31.00 / $42.50	Professional	26	$14.10	$31.00	$42.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.00 / $44.51 / $80.00	Professional	TC	$38.00	$44.51	$80.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.08 / $69.70 / $134.11	Professional		$55.08	$69.70	$134.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $20.28 / $37.47	Professional	26	$16.22	$20.28	$37.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.51 / $51.37 / $95.62	Professional	TC	$38.51	$51.37	$95.62
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $17.64 / $35.61 / $55.44	Facility	26	$17.64	$35.61	$55.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $218.85 / $218.85 / $218.85	Professional		$218.85	$218.85	$218.85
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $54.72 / $54.72 / $54.72	Professional	26	$54.72	$54.72	$54.72
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 $50.41 / $71.89 / $114.45	Professional		$50.41	$71.89	$114.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.97 / $19.48 / $32.51	Professional	26	$14.97	$19.48	$32.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.29 / $49.63 / $81.94	Professional	TC	$35.29	$49.63	$81.94