Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.56 / $10.56 / $19.11	Facility	26	$10.56	$10.56	$19.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.71 / $62.55 / $113.57	Professional		$36.71	$62.55	$113.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $13.72 / $39.94	Professional	26	$9.72	$13.72	$39.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.26 / $43.07 / $72.00	Professional	TC	$27.26	$43.07	$72.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $51.62 / $62.85	Professional		$32.08	$51.62	$62.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $13.51 / $17.01	Professional	26	$9.44	$13.51	$17.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $45.93 / $45.93 / $45.93	Professional	TC	$45.93	$45.93	$45.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.29 / $73.00 / $104.09	Professional		$35.29	$73.00	$104.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $31.00 / $54.51	Professional	26	$9.50	$31.00	$54.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.66 / $42.00 / $67.55	Professional	TC	$25.66	$42.00	$67.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.15 / $65.48 / $109.00	Professional		$47.15	$65.48	$109.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.25 / $16.88 / $29.17	Professional	26	$11.25	$16.88	$29.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.39 / $47.77 / $80.70	Professional	TC	$35.39	$47.77	$80.70
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $20.00 / $22.80	Facility	26	$15.41	$20.00	$22.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $73.00 / $146.63	Professional		$73.00	$73.00	$146.63
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $22.00 / $22.00	Professional	26	$22.00	$22.00	$22.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.91 / $37.00 / $57.46	Professional		$27.91	$37.00	$57.46
United Facility/Professional Professional Modifier Low / Median / High Price $46.95 / $57.26 / $90.02	Professional		$46.95	$57.26	$90.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.95 / $13.35 / $22.09	Professional	26	$10.95	$13.35	$22.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.39 / $43.83 / $67.09	Professional	TC	$34.39	$43.83	$67.09