Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.81 / $6.81 / $6.81	Facility	26	$6.81	$6.81	$6.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.09 / $17.09 / $69.09	Facility	TC	$17.09	$17.09	$69.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $25.17 / $52.89	Professional		$21.60	$25.17	$52.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $7.50 / $14.65	Professional	26	$6.81	$7.50	$14.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.20 / $17.67 / $28.04	Professional	TC	$15.20	$17.67	$28.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.99 / $7.51 / $13.44	Professional	26	$5.99	$7.51	$13.44
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $84.15 / $112.20 / $112.20	Facility	TC	$84.15	$112.20	$112.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.67 / $37.00 / $65.54	Professional		$26.67	$37.00	$65.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $19.00 / $28.33	Professional	26	$7.51	$19.00	$28.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $20.32 / $35.54	Professional	TC	$17.00	$20.32	$35.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.96 / $34.38 / $68.34	Professional		$26.96	$34.38	$68.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $10.75 / $19.96	Professional	26	$8.58	$10.75	$19.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.30 / $23.57 / $44.89	Professional	TC	$18.30	$23.57	$44.89
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.92 / $12.50 / $24.99	Facility	26	$10.92	$12.50	$24.99
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.34 / $26.34 / $57.23	Facility	TC	$26.34	$26.34	$57.23
Medcost Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $104.00 / $104.00	Professional		$104.00	$104.00	$104.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $29.70 / $29.70 / $29.70	Professional	26	$29.70	$29.70	$29.70
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 $24.67 / $33.36 / $54.86	Professional		$24.67	$33.36	$54.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $10.08 / $16.44	Professional	26	$7.79	$10.08	$16.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.78 / $23.60 / $38.82	Professional	TC	$16.78	$23.60	$38.82