Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.47 / $13.68 / $17.51	Facility	26	$12.47	$13.68	$17.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.90 / $108.50 / $478.00	Professional		$72.90	$108.50	$478.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $12.93 / $64.84	Professional	26	$11.14	$12.93	$64.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.54 / $40.75 / $292.64	Professional	52	$39.54	$40.75	$292.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.08 / $97.21 / $157.96	Professional	TC	$67.08	$97.21	$157.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.97 / $72.90 / $78.37	Professional		$61.97	$72.90	$78.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.33 / $19.60	Professional	26	$8.91	$15.33	$19.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $86.74 / $86.74 / $86.74	Professional	TC	$86.74	$86.74	$86.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.90 / $90.03 / $152.13	Professional		$72.90	$90.03	$152.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $26.00 / $36.94	Professional	26	$10.95	$26.00	$36.94
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.00 / $65.06 / $110.46	Professional	TC	$52.00	$65.06	$110.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.55 / $115.73 / $166.39	Professional		$82.55	$115.73	$166.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.64 / $14.98 / $24.42	Professional	26	$11.64	$14.98	$24.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.65 / $103.70 / $141.61	Professional	TC	$71.65	$103.70	$141.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.66 / $23.00 / $28.68	Facility	26	$13.66	$23.00	$28.68
Medcost Facility/Professional Professional Modifier Low / Median / High Price $291.12 / $291.12 / $291.12	Professional		$291.12	$291.12	$291.12
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $246.85 / $246.85 / $246.85	Professional	TC	$246.85	$246.85	$246.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.96 / $71.88 / $108.49	Professional		$51.96	$71.88	$108.49
United Facility/Professional Professional Modifier Low / Median / High Price $76.31 / $107.50 / $178.04	Professional		$76.31	$107.50	$178.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $12.99 / $22.43	Professional	26	$10.77	$12.99	$22.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.06 / $92.11 / $153.90	Professional	TC	$64.06	$92.11	$153.90