Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.05 / $20.05 / $35.38	Facility	26	$20.05	$20.05	$35.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.14 / $71.97 / $292.70	Professional		$37.14	$71.97	$292.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $25.06 / $134.00	Professional	26	$20.05	$25.06	$134.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.09 / $20.39 / $43.86	Professional	TC	$17.09	$20.39	$43.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.28 / $72.19 / $72.19	Professional		$34.28	$72.19	$72.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.70 / $39.47 / $39.47	Professional	26	$23.70	$39.47	$39.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.62 / $32.72 / $32.72	Professional	TC	$14.62	$32.72	$32.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.33 / $103.00 / $162.06	Professional		$40.33	$103.00	$162.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $32.00 / $53.40	Professional	26	$22.05	$32.00	$53.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $71.00 / $97.47	Professional	TC	$18.28	$71.00	$97.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.44 / $63.73 / $110.84	Professional		$47.44	$63.73	$110.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.06 / $31.61 / $49.80	Professional	26	$23.06	$31.61	$49.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $31.61 / $67.02	Professional	TC	$21.26	$31.61	$67.02
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $34.97 / $40.10 / $67.31	Facility	26	$34.97	$40.10	$67.31
Medcost Facility/Professional Professional Modifier Low / Median / High Price $163.72 / $163.72 / $163.72	Professional		$163.72	$163.72	$163.72
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $75.51 / $75.51 / $75.51	Professional	TC	$75.51	$75.51	$75.51
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 $40.49 / $53.50 / $97.74	Professional		$40.49	$53.50	$97.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.01 / $27.96 / $46.12	Professional	26	$21.01	$27.96	$46.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $24.49 / $54.02	Professional	TC	$18.05	$24.49	$54.02