Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.46 / $22.46 / $64.00	Facility	26	$22.46	$22.46	$64.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.73 / $92.43 / $149.43	Professional		$72.73	$92.43	$149.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.46 / $23.93 / $54.21	Professional	26	$22.46	$23.93	$54.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.48 / $67.09 / $113.92	Professional	TC	$51.48	$67.09	$113.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.39 / $81.39 / $81.39	Professional		$81.39	$81.39	$81.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $24.49 / $43.84	Professional	26	$19.85	$24.49	$43.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $90.45 / $90.45 / $90.45	Professional	TC	$90.45	$90.45	$90.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.10 / $106.05 / $227.00	Professional		$89.10	$106.05	$227.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $60.73 / $88.51	Professional	26	$24.49	$60.73	$88.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $64.61 / $168.00	Professional	TC	$33.50	$64.61	$168.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $116.83 / $204.76	Professional		$86.98	$116.83	$204.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $33.70 / $61.65	Professional	26	$25.11	$33.70	$61.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $82.04 / $147.51	Professional	TC	$61.88	$82.04	$147.51
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $38.29 / $48.03 / $93.14	Facility	26	$38.29	$48.03	$93.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $356.52 / $356.52 / $356.52	Professional		$356.52	$356.52	$356.52
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $97.85 / $97.85 / $97.85	Professional	26	$97.85	$97.85	$97.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $80.55 / $129.73	Professional		$44.14	$80.55	$129.73
United Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $111.23 / $184.60	Professional		$84.57	$111.23	$184.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $32.88 / $54.17	Professional	26	$23.81	$32.88	$54.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.02 / $77.20 / $128.12	Professional	TC	$60.02	$77.20	$128.12