Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.53 / $36.53 / $36.53	Facility	26	$36.53	$36.53	$36.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.32 / $103.70 / $294.10	Professional		$45.32	$103.70	$294.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $34.51 / $70.39	Professional	26	$24.78	$34.51	$70.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.78 / $30.69 / $98.28	Professional	TC	$8.78	$30.69	$98.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $53.35 / $53.35	Professional		$39.72	$53.35	$53.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.57 / $32.57 / $32.57	Professional	26	$32.57	$32.57	$32.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $7.82 / $7.82 / $7.82	Professional	TC	$7.82	$7.82	$7.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.63 / $104.00 / $188.68	Professional		$49.63	$104.00	$188.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $37.51 / $54.99	Professional	26	$25.00	$37.51	$54.99
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.42 / $79.00 / $138.91	Professional	TC	$9.42	$79.00	$138.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.93 / $121.89 / $173.48	Professional		$68.93	$121.89	$173.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.64 / $38.43 / $74.23	Professional	26	$30.64	$38.43	$74.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.92 / $86.79 / $128.53	Professional	TC	$14.92	$86.79	$128.53
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $41.73 / $41.73 / $84.36	Facility	26	$41.73	$41.73	$84.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $45.83 / $211.01	Professional		$45.83	$45.83	$211.01
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $68.75 / $68.75 / $316.52	Professional	50	$68.75	$68.75	$316.52
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $100.32 / $100.32 / $100.32	Professional	TC	$100.32	$100.32	$100.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.52 / $65.88 / $107.06	Professional		$37.52	$65.88	$107.06
United Facility/Professional Professional Modifier Low / Median / High Price $68.76 / $103.25 / $186.03	Professional		$68.76	$103.25	$186.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.34 / $35.33 / $64.39	Professional	26	$26.34	$35.33	$64.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.08 / $69.70 / $127.10	Professional	TC	$36.08	$69.70	$127.10