Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $89.48 / $580.35	Professional		$63.00	$89.48	$580.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.23 / $77.55 / $346.80	Professional	26	$23.23	$77.55	$346.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.46 / $56.98 / $388.08	Professional	TC	$29.46	$56.98	$388.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.37 / $47.79 / $86.89	Professional		$42.37	$47.79	$86.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $27.69 / $29.62	Professional	26	$12.88	$27.69	$29.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.57 / $30.57 / $30.57	Professional	TC	$30.57	$30.57	$30.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $54.60 / $90.79	Professional		$52.00	$54.60	$90.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.76 / $35.00 / $41.82	Professional	26	$25.76	$35.00	$41.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $17.85 / $61.44	Professional	TC	$17.00	$17.85	$61.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.91 / $40.39 / $97.28	Professional		$31.91	$40.39	$97.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.65 / $12.32 / $31.71	Professional	26	$10.65	$12.32	$31.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $26.92 / $68.31	Professional	TC	$21.26	$26.92	$68.31
Medcost Facility/Professional Facility Modifier Low / Median / High Price $66.97 / $94.22 / $98.51	Facility		$66.97	$94.22	$98.51
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $31.71 / $31.92 / $39.36	Facility	26	$31.71	$31.92	$39.36
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $62.51 / $63.75 / $88.25	Facility	TC	$62.51	$63.75	$88.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $76.48 / $116.54	Professional		$45.28	$76.48	$116.54
United Facility/Professional Professional Modifier Low / Median / High Price $37.71 / $61.43 / $156.82	Professional		$37.71	$61.43	$156.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.16 / $20.71 / $52.98	Professional	26	$12.16	$20.71	$52.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.00 / $38.76 / $103.63	Professional	TC	$25.00	$38.76	$103.63