Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.46 / $24.47 / $42.71	Facility	26	$24.46	$24.47	$42.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.74 / $50.14 / $183.60	Professional		$43.74	$50.14	$183.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.46 / $27.67 / $103.70	Professional	26	$24.46	$27.67	$103.70
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.37 / $38.22 / $78.70	Professional	52	$13.37	$38.22	$78.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.26 / $23.57 / $45.38	Professional	TC	$19.26	$23.57	$45.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.24 / $39.24 / $51.56	Professional		$39.24	$39.24	$51.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.31 / $28.70 / $47.79	Professional	26	$21.31	$28.70	$47.79
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $9.81 / $9.81 / $9.81	Professional	52	$9.81	$9.81	$9.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $25.30 / $29.76	Professional	TC	$22.85	$25.30	$29.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.96 / $55.15 / $81.31	Professional		$47.96	$55.15	$81.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.70 / $30.71 / $45.26	Professional	26	$26.70	$30.71	$45.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $24.70 / $41.84	Professional	TC	$21.26	$24.70	$41.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $68.40 / $118.00	Professional		$54.55	$68.40	$118.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.40 / $37.78 / $66.44	Professional	26	$30.40	$37.78	$66.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.16 / $30.12 / $56.37	Professional	TC	$24.16	$30.12	$56.37
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $44.09 / $44.38 / $88.77	Facility	26	$44.09	$44.38	$88.77
Medcost Facility/Professional Professional Modifier Low / Median / High Price $189.30 / $189.30 / $189.30	Professional		$189.30	$189.30	$189.30
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $106.57 / $106.57 / $106.57	Professional	26	$106.57	$106.57	$106.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $51.41 / $85.45	Professional		$28.98	$51.41	$85.45
United Facility/Professional Professional Modifier Low / Median / High Price $51.46 / $72.37 / $108.78	Professional		$51.46	$72.37	$108.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $36.90 / $58.62	Professional	26	$29.10	$36.90	$58.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.05 / $46.83	Professional	TC	$22.91	$29.05	$46.83