Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.91 / $83.00 / $83.00	Facility	26	$53.91	$83.00	$83.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $135.87 / $275.00	Professional		$71.34	$135.87	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $52.67 / $142.13	Professional	26	$34.07	$52.67	$142.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $81.47 / $220.00	Professional	TC	$32.72	$81.47	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $129.44 / $129.44	Professional		$72.31	$129.44	$129.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $37.82 / $62.97	Professional	26	$28.14	$37.82	$62.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.95 / $33.95 / $33.95	Professional	TC	$33.95	$33.95	$33.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $192.00 / $272.76	Professional		$72.31	$192.00	$272.76
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.18 / $48.00 / $76.13	Professional	26	$35.18	$48.00	$76.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $141.97 / $188.83	Professional	TC	$37.15	$141.97	$188.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.78 / $116.51 / $209.59	Professional		$71.78	$116.51	$209.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.18 / $51.45 / $88.04	Professional	26	$37.18	$51.45	$88.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.00 / $57.13 / $152.69	Professional	TC	$32.00	$57.13	$152.69
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $56.15 / $68.30 / $116.85	Facility	26	$56.15	$68.30	$116.85
Medcost Facility/Professional Professional Modifier Low / Median / High Price $259.44 / $259.44 / $259.44	Professional		$259.44	$259.44	$259.44
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $139.07 / $139.07 / $139.07	Professional	26	$139.07	$139.07	$139.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $51.41 / $125.61	Professional		$28.98	$51.41	$125.61
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $105.44 / $198.94	Professional		$68.48	$105.44	$198.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.52 / $53.02 / $81.17	Professional	26	$37.52	$53.02	$81.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.36 / $48.73 / $114.40	Professional	TC	$29.36	$48.73	$114.40