Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $1,548.82 / $1,862.09	Facility		$186.21	$1,548.82	$1,862.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $104.71	Facility	26	$44.67	$44.67	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $89.13 / $295.12	Professional		$56.23	$89.13	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $117.49	Professional	26	$33.11	$50.12	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.88 / $147.91	Professional	TC	$25.12	$33.88	$147.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $31.62 / $53.70	Professional		$26.92	$31.62	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $39.81 / $66.07	Professional	26	$29.51	$39.81	$66.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $14.45 / $22.91	Professional	TC	$12.02	$14.45	$22.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $251.19 / $446.68	Facility		$141.25	$251.19	$446.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $134.90 / $234.42	Professional		$63.10	$134.90	$234.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $75.86 / $141.25	Professional	26	$36.31	$75.86	$141.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $104.71	Professional	TC	$19.95	$28.84	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Facility		$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $158.49 / $295.12	Professional		$79.43	$158.49	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $83.18 / $128.82	Professional	26	$44.67	$83.18	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $89.13 / $186.21	Professional	TC	$31.62	$89.13	$186.21
Medcost Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $120.23 / $363.08	Facility		$64.57	$120.23	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $1,202.26 / $3,548.13	Facility		$380.19	$1,202.26	$3,548.13
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $109.65 / $302.00	Professional		$61.66	$109.65	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $61.66 / $120.23	Professional	26	$34.67	$61.66	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $44.67 / $190.55	Professional	TC	$25.70	$44.67	$190.55