Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.41 / $9.41 / $16.57	Facility	26	$9.41	$9.41	$16.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.83 / $36.79 / $519.45	Facility	TC	$20.83	$36.79	$519.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $32.39 / $77.70	Professional		$30.19	$32.39	$77.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $12.23 / $57.80	Professional	26	$9.41	$12.23	$57.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $22.22 / $41.60	Professional	TC	$19.89	$22.22	$41.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $35.86 / $56.73	Professional		$34.04	$35.86	$56.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $11.14 / $18.54	Professional	26	$8.27	$11.14	$18.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.17 / $41.17 / $41.17	Professional	TC	$41.17	$41.17	$41.17
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $75.73 / $100.98 / $100.98	Facility	TC	$75.73	$100.98	$100.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $45.00 / $72.50	Professional		$33.36	$45.00	$72.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $25.00 / $35.52	Professional	26	$10.36	$25.00	$35.52
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.00 / $24.15 / $40.01	Professional	TC	$20.00	$24.15	$40.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $42.00 / $79.88	Professional		$32.70	$42.00	$79.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $14.62 / $27.57	Professional	26	$11.79	$14.62	$27.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $27.61 / $52.14	Professional	TC	$20.70	$27.61	$52.14
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $20.13 / $34.19	Facility	26	$12.88	$20.13	$34.19
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $29.85 / $29.85 / $55.99	Facility	TC	$29.85	$29.85	$55.99
Medcost Facility/Professional Professional Modifier Low / Median / High Price $131.82 / $131.82 / $131.82	Professional		$131.82	$131.82	$131.82
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $40.96 / $40.96	Professional	26	$40.96	$40.96	$40.96
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 $29.91 / $41.92 / $68.06	Professional		$29.91	$41.92	$68.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.09 / $22.63	Professional	26	$10.72	$14.09	$22.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $27.32 / $45.97	Professional	TC	$18.97	$27.32	$45.97