Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.19 / $22.19 / $63.24	Facility	26	$22.19	$22.19	$63.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $93.84 / $373.15	Professional		$86.06	$93.84	$373.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.19 / $25.51 / $67.59	Professional	26	$22.19	$25.51	$67.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.11 / $66.56 / $140.53	Professional	TC	$61.11	$66.56	$140.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.45 / $103.12 / $103.12	Professional		$77.45	$103.12	$103.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.36 / $27.42 / $36.82	Professional	26	$19.36	$27.42	$36.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $100.42 / $100.42 / $100.42	Professional	TC	$100.42	$100.42	$100.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $100.73 / $210.00	Professional		$65.00	$100.73	$210.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.19 / $31.49 / $100.00	Professional	26	$24.19	$31.49	$100.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.00 / $72.09 / $110.00	Professional	TC	$35.00	$72.09	$110.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.46 / $116.42 / $208.18	Professional		$92.46	$116.42	$208.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.90 / $34.61 / $55.16	Professional	26	$27.90	$34.61	$55.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.85 / $85.18 / $156.83	Professional	TC	$63.85	$85.18	$156.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $35.08 / $44.64 / $73.16	Facility	26	$35.08	$44.64	$73.16
Medcost Facility/Professional Professional Modifier Low / Median / High Price $383.71 / $383.71 / $383.71	Professional		$383.71	$383.71	$383.71
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $96.67 / $96.67 / $96.67	Professional	26	$96.67	$96.67	$96.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $98.86 / $180.58	Professional		$44.14	$98.86	$180.58
United Facility/Professional Professional Modifier Low / Median / High Price $86.78 / $115.85 / $197.44	Professional		$86.78	$115.85	$197.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $30.66 / $54.95	Professional	26	$23.93	$30.66	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.03 / $87.52 / $147.63	Professional	TC	$64.03	$87.52	$147.63