Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.14 / $20.14 / $35.95	Facility	26	$20.14	$20.14	$35.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.60 / $69.65 / $114.65	Professional		$31.60	$69.65	$114.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.14 / $23.53 / $48.61	Professional	26	$20.14	$23.53	$48.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.47 / $18.57 / $77.37	Professional	TC	$11.47	$18.57	$77.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $48.75 / $48.75	Professional		$48.75	$48.75	$48.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.23 / $33.00 / $44.69	Professional	26	$18.23	$33.00	$44.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.63 / $110.00 / $193.41	Professional		$38.63	$110.00	$193.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.47 / $43.00 / $76.48	Professional	26	$22.47	$43.00	$76.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.48 / $67.00 / $117.81	Professional	TC	$15.48	$67.00	$117.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $76.70 / $135.97	Professional		$51.25	$76.70	$135.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.54 / $33.72 / $52.09	Professional	26	$25.54	$33.72	$52.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.71 / $48.58 / $87.15	Professional	TC	$18.71	$48.58	$87.15
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $39.11 / $45.00 / $78.51	Facility	26	$39.11	$45.00	$78.51
Medcost Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $35.14 / $53.77	Professional		$25.45	$35.14	$53.77
United Facility/Professional Professional Modifier Low / Median / High Price $45.95 / $72.15 / $125.58	Professional		$45.95	$72.15	$125.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.65 / $34.15 / $49.10	Professional	26	$23.65	$34.15	$49.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.43 / $42.56 / $74.83	Professional	TC	$21.43	$42.56	$74.83