Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.55 / $28.56 / $40.88	Facility	26	$28.55	$28.56	$40.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $61.76 / $104.67	Professional		$57.31	$61.76	$104.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.48 / $28.80 / $47.05	Professional	26	$25.48	$28.80	$47.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.82 / $33.20 / $58.02	Professional	TC	$30.82	$33.20	$58.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.28 / $85.28 / $85.28	Professional		$85.28	$85.28	$85.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $45.73 / $45.73	Professional	26	$23.50	$45.73	$45.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.51 / $57.51 / $57.51	Professional	TC	$57.51	$57.51	$57.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.68 / $110.00 / $164.95	Professional		$57.68	$110.00	$164.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $45.00 / $68.95	Professional	26	$25.55	$45.00	$68.95
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.13 / $65.00 / $99.60	Professional	TC	$32.13	$65.00	$99.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.84 / $77.93 / $179.00	Professional		$57.84	$77.93	$179.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.68 / $37.82 / $62.46	Professional	26	$28.68	$37.82	$62.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.82 / $40.75 / $91.74	Professional	TC	$27.82	$40.75	$91.74
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $29.90 / $43.00 / $58.21	Facility	26	$29.90	$43.00	$58.21
Medcost Facility/Professional Professional Modifier Low / Median / High Price $143.25 / $182.00 / $182.00	Professional		$143.25	$182.00	$182.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $43.00 / $43.00 / $43.00	Professional	26	$43.00	$43.00	$43.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $53.15 / $99.31	Professional		$30.24	$53.15	$99.31
United Facility/Professional Professional Modifier Low / Median / High Price $48.68 / $57.26 / $89.95	Professional		$48.68	$57.26	$89.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.64 / $28.72 / $45.32	Professional	26	$23.64	$28.72	$45.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.39 / $29.60 / $44.71	Professional	TC	$24.39	$29.60	$44.71