Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.04 / $59.35 / $90.46	Professional		$49.04	$59.35	$90.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.52 / $27.46 / $142.80	Professional	26	$5.52	$27.46	$142.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.52 / $37.61 / $48.07	Professional	TC	$28.52	$37.61	$48.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.13 / $30.73 / $61.46	Professional		$30.13	$30.73	$61.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $27.06 / $35.81	Professional	26	$12.59	$27.06	$35.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.46 / $140.00 / $147.00	Professional		$61.46	$140.00	$147.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.17 / $78.00 / $81.90	Professional	26	$25.17	$78.00	$81.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.29 / $62.00 / $65.09	Professional	TC	$36.29	$62.00	$65.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.44 / $52.88 / $198.00	Professional		$31.44	$52.88	$198.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $27.40 / $93.56	Professional	26	$13.82	$27.40	$93.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.93 / $24.52 / $74.98	Professional	TC	$17.93	$24.52	$74.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $60.73 / $137.24 / $148.68	Facility		$60.73	$137.24	$148.68
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $44.63 / $81.00 / $120.00	Facility	26	$44.63	$81.00	$120.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $51.18 / $78.47 / $78.47	Facility	TC	$51.18	$78.47	$78.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $44.97 / $78.76	Professional		$25.98	$44.97	$78.76
United Facility/Professional Professional Modifier Low / Median / High Price $38.14 / $56.70 / $170.13	Professional		$38.14	$56.70	$170.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.54 / $27.96 / $109.30	Professional	26	$15.54	$27.96	$109.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.48 / $26.30 / $100.45	Professional	TC	$20.48	$26.30	$100.45