Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $464.25 / $4,230.00 / $9,870.00	Facility		$464.25	$4,230.00	$9,870.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $153.63 / $153.63 / $349.27	Facility	26	$153.63	$153.63	$349.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.22 / $464.25 / $912.07	Professional		$368.22	$464.25	$912.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.85 / $153.63 / $349.27	Professional	26	$122.85	$153.63	$349.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.11 / $310.62 / $514.59	Professional	TC	$214.11	$310.62	$514.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $393.79 / $798.14 / $1,315.18	Facility		$393.79	$798.14	$1,315.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.50 / $364.20 / $701.83	Professional		$303.50	$364.20	$701.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $116.35 / $245.00 / $402.26	Professional	26	$116.35	$245.00	$402.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.50 / $207.52 / $395.04	Professional	TC	$58.50	$207.52	$395.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $288.10 / $288.10 / $370.22	Facility		$288.10	$288.10	$370.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $356.79 / $458.80 / $973.11	Professional		$356.79	$458.80	$973.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $143.03 / $179.89 / $326.94	Professional	26	$143.03	$179.89	$326.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $217.54 / $283.83 / $651.08	Professional	TC	$217.54	$283.83	$651.08
Medcost Facility/Professional Facility Modifier Low / Median / High Price $381.30 / $464.25 / $778.59	Facility		$381.30	$464.25	$778.59
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $166.84 / $166.84 / $237.01	Facility	26	$166.84	$166.84	$237.01
Medcost Facility/Professional Professional Modifier Low / Median / High Price $142.91 / $254.90 / $438.15	Professional		$142.91	$254.90	$438.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $133.98 / $260.18 / $493.23	Professional		$133.98	$260.18	$493.23
United Facility/Professional Facility Modifier Low / Median / High Price $461.00 / $3,866.00 / $6,584.00	Facility		$461.00	$3,866.00	$6,584.00
United Facility/Professional Professional Modifier Low / Median / High Price $336.10 / $489.80 / $879.04	Professional		$336.10	$489.80	$879.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $122.51 / $173.42 / $329.33	Professional	26	$122.51	$173.42	$329.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.14 / $313.26 / $635.07	Professional	TC	$211.14	$313.26	$635.07