Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.50 / $37.82 / $53.31	Facility	26	$30.50	$37.82	$53.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.50 / $135.83 / $555.00	Professional		$76.50	$135.83	$555.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $48.38 / $198.25	Professional	26	$30.50	$48.38	$198.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $56.82 / $106.10	Professional	TC	$46.00	$56.82	$106.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.72 / $148.93 / $148.93	Professional		$70.72	$148.93	$148.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.66 / $50.98 / $59.64	Professional	26	$26.66	$50.98	$59.64
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.90 / $49.88 / $89.29	Professional	TC	$39.90	$49.88	$89.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.20 / $121.84 / $243.00	Professional		$83.20	$121.84	$243.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $80.00 / $121.72	Professional	26	$33.32	$80.00	$121.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.00 / $50.13 / $167.00	Professional	TC	$35.00	$50.13	$167.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.28 / $113.12 / $198.99	Professional		$91.28	$113.12	$198.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.83 / $47.04 / $74.17	Professional	26	$33.83	$47.04	$74.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $68.81 / $120.56	Professional	TC	$54.95	$68.81	$120.56
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $52.82 / $65.00 / $99.85	Facility	26	$52.82	$65.00	$99.85
Medcost Facility/Professional Professional Modifier Low / Median / High Price $335.91 / $335.91 / $335.91	Professional		$335.91	$335.91	$335.91
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $203.14 / $203.14 / $203.14	Professional	TC	$203.14	$203.14	$203.14
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 $82.82 / $105.03 / $173.06	Professional		$82.82	$105.03	$173.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.38 / $42.08 / $72.68	Professional	26	$31.38	$42.08	$72.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.31 / $64.30 / $109.73	Professional	TC	$50.31	$64.30	$109.73