Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.85 / $10.86 / $31.24	Facility	26	$10.85	$10.86	$31.24
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.32 / $30.15 / $448.80	Facility	TC	$24.32	$30.15	$448.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $36.53 / $66.12	Professional		$31.57	$36.53	$66.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.43 / $11.55 / $19.55	Professional	26	$10.43	$11.55	$19.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $25.42 / $56.30	Professional	TC	$21.33	$25.42	$56.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.05 / $32.72 / $55.63	Professional		$31.05	$32.72	$55.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $12.68 / $21.39	Professional	26	$9.67	$12.68	$21.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.17 / $37.17 / $37.17	Professional	TC	$37.17	$37.17	$37.17
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 $38.50 / $52.00 / $85.00	Professional		$38.50	$52.00	$85.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $30.00 / $40.47	Professional	26	$11.95	$30.00	$40.47
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.00 / $27.61 / $46.00	Professional	TC	$22.00	$27.61	$46.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $47.90 / $87.75	Professional		$38.15	$47.90	$87.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.59 / $17.13 / $31.81	Professional	26	$13.59	$17.13	$31.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.13 / $32.18 / $59.38	Professional	TC	$24.13	$32.18	$59.38
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $14.85 / $26.90 / $39.44	Facility	26	$14.85	$26.90	$39.44
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $34.77 / $34.77 / $65.20	Facility	TC	$34.77	$34.77	$65.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $154.66 / $154.66 / $154.66	Professional		$154.66	$154.66	$154.66
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $47.25 / $47.25 / $47.25	Professional	26	$47.25	$47.25	$47.25
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 $34.90 / $50.90 / $79.84	Professional		$34.90	$50.90	$79.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.66 / $16.45 / $27.47	Professional	26	$12.66	$16.45	$27.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $32.20 / $53.43	Professional	TC	$22.11	$32.20	$53.43