Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.24 / $25.24 / $25.24	Facility	26	$25.24	$25.24	$25.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.18 / $70.01 / $119.80	Professional		$55.18	$70.01	$119.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $26.61 / $48.36	Professional	26	$25.24	$26.61	$48.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.95 / $28.66 / $39.86	Professional	52	$24.95	$28.66	$39.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.94 / $43.74 / $71.43	Professional	TC	$29.94	$43.74	$71.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.70 / $93.00 / $181.30	Professional		$61.70	$93.00	$181.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $50.00 / $87.85	Professional	26	$28.07	$50.00	$87.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.64 / $45.15 / $102.00	Professional	TC	$33.64	$45.15	$102.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $92.77 / $146.00	Professional		$67.56	$92.77	$146.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.01 / $37.36 / $60.72	Professional	26	$26.01	$37.36	$60.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.29 / $53.01 / $86.27	Professional	TC	$35.29	$53.01	$86.27
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $41.24 / $49.00 / $73.42	Facility	26	$41.24	$49.00	$73.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $238.68 / $238.68 / $238.68	Professional		$238.68	$238.68	$238.68
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $108.82 / $108.82 / $108.82	Professional	26	$108.82	$108.82	$108.82
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $358.03 / $358.03 / $358.03	Professional	50	$358.03	$358.03	$358.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $51.99 / $90.40	Professional		$29.53	$51.99	$90.40
United Facility/Professional Professional Modifier Low / Median / High Price $59.77 / $74.75 / $130.40	Professional		$59.77	$74.75	$130.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.53 / $31.94 / $57.16	Professional	26	$25.53	$31.94	$57.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.08 / $43.26 / $69.95	Professional	TC	$32.08	$43.26	$69.95