Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $59.93 / $121.85	Professional		$43.19	$59.93	$121.85
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.36 / $66.36 / $66.36	Professional	25	$66.36	$66.36	$66.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.96 / $26.23 / $62.27	Professional	26	$18.96	$26.23	$62.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $435.50 / $435.50 / $435.50	Professional	50	$435.50	$435.50	$435.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.60 / $29.97 / $35.43	Professional	52	$21.60	$29.97	$35.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $34.00 / $47.99	Professional	TC	$26.13	$34.00	$47.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.16 / $57.16 / $62.88	Professional		$53.16	$57.16	$62.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.56 / $26.56 / $26.56	Professional	26	$26.56	$26.56	$26.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $216.24 / $317.05 / $384.48	Facility		$216.24	$317.05	$384.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.16 / $62.00 / $95.67	Professional		$57.16	$62.00	$95.67
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.71 / $50.00 / $64.93	Professional	26	$24.71	$50.00	$64.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.00 / $17.28 / $43.64	Professional	TC	$13.00	$17.28	$43.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.69 / $67.80 / $103.76	Professional		$51.69	$67.80	$103.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.14 / $29.00 / $45.64	Professional	26	$21.14	$29.00	$45.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $43.99 / $58.12	Professional	TC	$28.39	$43.99	$58.12
Medcost Facility/Professional Facility Modifier Low / Median / High Price $51.61 / $70.43 / $102.99	Facility		$51.61	$70.43	$102.99
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $26.00 / $28.00 / $47.99	Facility	26	$26.00	$28.00	$47.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $43.06 / $81.68	Professional		$32.34	$43.06	$81.68
United Facility/Professional Professional Modifier Low / Median / High Price $44.97 / $59.74 / $83.58	Professional		$44.97	$59.74	$83.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.46 / $24.49 / $36.77	Professional	26	$19.46	$24.49	$36.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.49 / $34.29 / $49.71	Professional	TC	$25.49	$34.29	$49.71