Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.03 / $15.04 / $26.16	Facility	26	$15.03	$15.04	$26.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.65 / $101.24 / $166.58	Professional		$81.65	$101.24	$166.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.04 / $17.86 / $96.17	Professional	26	$15.04	$17.86	$96.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.10 / $82.59 / $143.35	Professional	TC	$61.10	$82.59	$143.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $69.48 / $69.48	Professional		$69.48	$69.48	$69.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.73 / $18.75 / $31.25	Professional	26	$13.73	$18.75	$31.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $92.14 / $144.08	Professional		$81.00	$92.14	$144.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $24.00 / $37.90	Professional	26	$16.89	$24.00	$37.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.00 / $69.95 / $104.71	Professional	TC	$57.00	$69.95	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.43 / $108.78 / $223.96	Professional		$80.43	$108.78	$223.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $22.67 / $43.60	Professional	26	$17.18	$22.67	$43.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.51 / $84.29 / $162.93	Professional	TC	$61.51	$84.29	$162.93
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $27.41 / $30.26 / $54.75	Facility	26	$27.41	$30.26	$54.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $366.79 / $366.79 / $366.79	Professional		$366.79	$366.79	$366.79
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $300.02 / $300.02 / $300.02	Professional	TC	$300.02	$300.02	$300.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.96 / $71.07 / $107.83	Professional		$51.96	$71.07	$107.83
United Facility/Professional Professional Modifier Low / Median / High Price $84.50 / $111.96 / $185.82	Professional		$84.50	$111.96	$185.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.60 / $22.90 / $35.47	Professional	26	$17.60	$22.90	$35.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.97 / $89.09 / $149.47	Professional	TC	$65.97	$89.09	$149.47