Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.64 / $29.64 / $84.55	Facility	26	$29.64	$29.64	$84.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.01 / $99.25 / $530.40	Professional		$85.01	$99.25	$530.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.64 / $32.67 / $89.92	Professional	26	$29.64	$32.67	$89.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $163.80 / $832.00 / $852.15	Professional	50	$163.80	$832.00	$852.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.37 / $66.03 / $116.77	Professional	TC	$55.37	$66.03	$116.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.84 / $99.19 / $161.47	Professional		$75.84	$99.19	$161.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.86 / $35.09 / $39.69	Professional	26	$27.86	$35.09	$39.69
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $113.78 / $148.79 / $275.62	Professional	50	$113.78	$148.79	$275.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.70 / $47.70 / $74.09	Professional	TC	$47.70	$47.70	$74.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $106.11 / $178.75	Professional		$92.00	$106.11	$178.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.64 / $55.00 / $86.06	Professional	26	$32.64	$55.00	$86.06
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.00 / $59.62 / $91.88	Professional	TC	$37.00	$59.62	$91.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.81 / $128.75 / $212.03	Professional		$105.81	$128.75	$212.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.79 / $45.98 / $72.79	Professional	26	$36.79	$45.98	$72.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.20 / $83.35 / $137.25	Professional	TC	$68.20	$83.35	$137.25
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $54.27 / $54.68 / $96.38	Facility	26	$54.27	$54.68	$96.38
Medcost Facility/Professional Professional Modifier Low / Median / High Price $372.38 / $372.38 / $372.38	Professional		$372.38	$372.38	$372.38
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $127.88 / $127.88 / $127.88	Professional	26	$127.88	$127.88	$127.88
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $558.57 / $558.57 / $558.57	Professional	50	$558.57	$558.57	$558.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $83.61 / $137.35	Professional		$44.14	$83.61	$137.35
United Facility/Professional Professional Modifier Low / Median / High Price $89.37 / $117.48 / $192.79	Professional		$89.37	$117.48	$192.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.74 / $39.86 / $68.31	Professional	26	$29.74	$39.86	$68.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.37 / $71.98 / $129.27	Professional	TC	$58.37	$71.98	$129.27