Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.33 / $23.34 / $41.21	Facility	26	$23.33	$23.34	$41.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.73 / $100.18 / $348.88	Professional		$48.73	$100.18	$348.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.34 / $27.54 / $166.00	Professional	26	$23.34	$27.54	$166.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $37.77 / $93.00	Professional	TC	$24.55	$37.77	$93.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $45.74 / $66.31	Professional		$44.45	$45.74	$66.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $39.19 / $46.11	Professional	26	$20.60	$39.19	$46.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.30 / $41.30 / $42.19	Professional	TC	$41.30	$41.30	$42.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.26 / $103.00 / $184.96	Professional		$55.26	$103.00	$184.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.76 / $45.50 / $80.00	Professional	26	$25.76	$45.50	$80.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.50 / $57.50 / $113.70	Professional	TC	$29.50	$57.50	$113.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $89.78 / $147.37	Professional		$59.78	$89.78	$147.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.75 / $36.53 / $58.28	Professional	26	$26.75	$36.53	$58.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.87 / $51.77 / $90.40	Professional	TC	$29.87	$51.77	$90.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $42.12 / $49.00 / $72.00	Facility	26	$42.12	$49.00	$72.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $209.06 / $209.06 / $209.06	Professional		$209.06	$209.06	$209.06
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $107.42 / $107.42 / $107.42	Professional	TC	$107.42	$107.42	$107.42
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 $52.12 / $84.02 / $148.86	Professional		$52.12	$84.02	$148.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.27 / $32.54 / $55.33	Professional	26	$24.27	$32.54	$55.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.38 / $47.21 / $100.60	Professional	TC	$26.38	$47.21	$100.60