Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $27.93 / $49.21	Facility	26	$27.92	$27.93	$49.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $55.86 / $224.00	Professional		$28.64	$55.86	$224.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $30.76 / $135.18	Professional	26	$17.17	$30.76	$135.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $540.40 / $540.40 / $1,178.07	Professional	50	$540.40	$540.40	$1,178.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.45 / $11.21 / $58.97	Professional	TC	$7.45	$11.21	$58.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.13 / $102.87 / $105.22	Professional		$58.13	$102.87	$105.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.80 / $55.06 / $55.06	Professional	26	$26.80	$55.06	$55.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $39.22 / $39.22	Professional	TC	$23.23	$39.22	$39.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $47.47 / $73.48	Professional		$27.00	$47.47	$73.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.00 / $27.13 / $41.73	Professional	26	$17.00	$27.13	$41.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $14.48 / $35.29	Professional	TC	$10.00	$14.48	$35.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.32 / $51.26 / $103.61	Professional		$31.32	$51.26	$103.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $28.91 / $56.75	Professional	26	$21.23	$28.91	$56.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.09 / $14.95 / $46.33	Professional	TC	$10.09	$14.95	$46.33
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $28.91 / $29.25 / $62.71	Facility	26	$28.91	$29.25	$62.71
Medcost Facility/Professional Professional Modifier Low / Median / High Price $201.44 / $201.44 / $201.44	Professional		$201.44	$201.44	$201.44
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $302.16 / $302.16 / $302.16	Professional	50	$302.16	$302.16	$302.16
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $116.88 / $116.88 / $116.88	Professional	TC	$116.88	$116.88	$116.88
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 $28.82 / $54.04 / $96.68	Professional		$28.82	$54.04	$96.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.37 / $24.90 / $48.15	Professional	26	$19.37	$24.90	$48.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.25 / $27.22 / $51.35	Professional	TC	$9.25	$27.22	$51.35