Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.37 / $28.97 / $65.86	Facility	26	$23.37	$28.97	$65.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.88 / $79.34 / $142.02	Professional		$46.88	$79.34	$142.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $30.38 / $118.30	Professional	26	$23.37	$30.38	$118.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.44 / $26.62 / $47.27	Professional	52	$23.44	$26.62	$47.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $53.64 / $73.68	Professional	TC	$23.51	$53.64	$73.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.89 / $94.73 / $94.73	Professional		$56.89	$94.73	$94.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.92 / $38.78 / $45.63	Professional	26	$8.92	$38.78	$45.63
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $74.09 / $74.09 / $74.09	Professional	52	$74.09	$74.09	$74.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $27.43 / $38.40	Professional	TC	$22.74	$27.43	$38.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $96.00 / $143.91	Professional		$52.92	$96.00	$143.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.49 / $60.00 / $89.18	Professional	26	$25.49	$60.00	$89.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.23 / $36.00 / $63.30	Professional	TC	$26.23	$36.00	$63.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.59 / $90.22 / $141.78	Professional		$69.59	$90.22	$141.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $34.04 / $54.60	Professional	26	$25.11	$34.04	$54.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.38 / $57.13 / $90.16	Professional	TC	$39.38	$57.13	$90.16
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $39.14 / $46.00 / $66.59	Facility	26	$39.14	$46.00	$66.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $210.35 / $210.35 / $210.35	Professional		$210.35	$210.35	$210.35
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $108.60 / $108.60 / $108.60	Professional	TC	$108.60	$108.60	$108.60
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 $68.41 / $82.83 / $130.76	Professional		$68.41	$82.83	$130.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.67 / $31.15 / $51.86	Professional	26	$23.67	$31.15	$51.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.73 / $55.26 / $94.72	Professional	TC	$41.73	$55.26	$94.72