Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.48 / $32.83 / $74.77	Facility	26	$26.48	$32.83	$74.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.12 / $122.89 / $507.96	Professional		$67.12	$122.89	$507.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.48 / $46.26 / $180.00	Professional	26	$26.48	$46.26	$180.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.64 / $54.95 / $94.12	Professional	TC	$40.64	$54.95	$94.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.86 / $110.86 / $130.97	Professional		$66.86	$110.86	$130.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.41 / $43.99 / $51.75	Professional	26	$23.41	$43.99	$51.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $61.98 / $63.31	Professional	TC	$58.88	$61.98	$63.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.17 / $108.00 / $165.49	Professional		$73.17	$108.00	$165.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $48.00 / $85.38	Professional	26	$28.91	$48.00	$85.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.19 / $60.00 / $97.16	Professional	TC	$30.19	$60.00	$97.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.35 / $106.75 / $176.93	Professional		$82.35	$106.75	$176.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.38 / $41.02 / $63.57	Professional	26	$29.38	$41.02	$63.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.91 / $64.03 / $106.56	Professional	TC	$49.91	$64.03	$106.56
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $45.33 / $55.00 / $82.75	Facility	26	$45.33	$55.00	$82.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $293.63 / $293.63 / $293.63	Professional		$293.63	$293.63	$293.63
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $114.12 / $114.12 / $114.12	Professional	26	$114.12	$114.12	$114.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $53.91 / $137.35	Professional		$29.53	$53.91	$137.35
United Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $92.47 / $156.56	Professional		$72.70	$92.47	$156.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.22 / $36.35 / $59.76	Professional	26	$27.22	$36.35	$59.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.48 / $56.83 / $97.43	Professional	TC	$44.48	$56.83	$97.43