Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.01 / $27.01 / $27.01	Facility	26	$27.01	$27.01	$27.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.50 / $79.14 / $124.27	Professional		$61.50	$79.14	$124.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.01 / $29.80 / $50.93	Professional	26	$27.01	$29.80	$50.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $217.92 / $217.92 / $217.92	Professional	50	$217.92	$217.92	$217.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.49 / $47.00 / $78.31	Professional	TC	$34.49	$47.00	$78.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.48 / $114.00 / $174.68	Professional		$67.48	$114.00	$174.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.01 / $37.51 / $63.42	Professional	26	$30.01	$37.51	$63.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.47 / $46.85 / $93.33	Professional	TC	$37.47	$46.85	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.18 / $105.68 / $177.47	Professional		$81.18	$105.68	$177.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.31 / $43.12 / $67.98	Professional	26	$31.31	$43.12	$67.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.34 / $63.49 / $103.19	Professional	TC	$48.34	$63.49	$103.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $46.59 / $60.00 / $84.11	Facility	26	$46.59	$60.00	$84.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $269.95 / $269.95 / $269.95	Professional		$269.95	$269.95	$269.95
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $404.95 / $404.95 / $404.95	Professional	50	$404.95	$404.95	$404.95
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $153.49 / $153.49 / $153.49	Professional	TC	$153.49	$153.49	$153.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $53.91 / $137.11	Professional		$29.53	$53.91	$137.11
United Facility/Professional Professional Modifier Low / Median / High Price $75.20 / $101.41 / $160.83	Professional		$75.20	$101.41	$160.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.19 / $37.24 / $61.86	Professional	26	$30.19	$37.24	$61.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.14 / $61.52 / $101.92	Professional	TC	$46.14	$61.52	$101.92