Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.20 / $35.20 / $35.20	Facility	26	$35.20	$35.20	$35.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $103.88 / $232.00	Professional		$64.31	$103.88	$232.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.58 / $34.82 / $52.55	Professional	26	$29.58	$34.82	$52.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $65.59 / $81.03	Professional	TC	$33.03	$65.59	$81.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.08 / $85.08 / $85.08	Professional		$85.08	$85.08	$85.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.34 / $47.34 / $47.34	Professional	26	$47.34	$47.34	$47.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $91.48 / $118.92	Professional		$65.00	$91.48	$118.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.56 / $50.00 / $72.38	Professional	26	$31.56	$50.00	$72.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $31.36 / $72.11	Professional	TC	$15.00	$31.36	$72.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.25 / $91.36 / $179.62	Professional		$54.25	$91.36	$179.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.72 / $44.10 / $66.45	Professional	26	$34.72	$44.10	$66.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.24 / $58.79 / $119.75	Professional	TC	$14.24	$58.79	$119.75
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $34.13 / $43.00 / $70.83	Facility	26	$34.13	$43.00	$70.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $86.86 / $137.79	Professional		$45.41	$86.86	$137.79
United Facility/Professional Professional Modifier Low / Median / High Price $55.79 / $95.52 / $147.02	Professional		$55.79	$95.52	$147.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.37 / $36.71 / $59.97	Professional	26	$30.37	$36.71	$59.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $54.56 / $93.68	Professional	TC	$19.93	$54.56	$93.68