Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.54 / $6.55 / $11.53	Facility	26	$6.54	$6.55	$11.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.15 / $30.11 / $93.50	Professional		$21.15	$30.11	$93.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $7.81 / $27.46	Professional	26	$6.55	$7.81	$27.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.22 / $56.40 / $80.58	Professional	50	$50.22	$56.40	$80.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.36 / $11.69 / $14.55	Professional	52	$9.36	$11.69	$14.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $18.48 / $35.65	Professional	TC	$16.82	$18.48	$35.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.01 / $38.78 / $45.63	Professional		$21.01	$38.78	$45.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.85 / $7.21 / $12.91	Professional	26	$5.85	$7.21	$12.91
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.10 / $41.10 / $41.10	Professional	50	$41.10	$41.10	$41.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $27.81 / $32.72	Professional	TC	$19.64	$27.81	$32.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.49 / $33.14 / $55.86	Professional		$25.49	$33.14	$55.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $17.00 / $23.89	Professional	26	$7.21	$17.00	$23.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $19.19 / $30.90	Professional	TC	$15.00	$19.19	$30.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.21 / $33.00 / $58.93	Professional		$24.21	$33.00	$58.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $10.65 / $17.92	Professional	26	$7.38	$10.65	$17.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.01 / $23.54 / $41.01	Professional	TC	$17.01	$23.54	$41.01
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $14.00 / $23.01	Facility	26	$11.13	$14.00	$23.01
Medcost Facility/Professional Professional Modifier Low / Median / High Price $102.82 / $102.82 / $102.82	Professional		$102.82	$102.82	$102.82
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $28.52 / $28.52	Professional	26	$28.52	$28.52	$28.52
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $154.22 / $154.22 / $154.22	Professional	50	$154.22	$154.22	$154.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $34.60 / $51.41	Professional		$25.48	$34.60	$51.41
United Facility/Professional Professional Modifier Low / Median / High Price $23.07 / $32.74 / $53.08	Professional		$23.07	$32.74	$53.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.27 / $9.94 / $15.77	Professional	26	$7.27	$9.94	$15.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.72 / $22.79 / $37.82	Professional	TC	$15.72	$22.79	$37.82