Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.69 / $535.20 / $1,876.80	Facility		$77.69	$535.20	$1,876.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.46 / $45.46 / $103.77	Facility	26	$45.46	$45.46	$103.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.55 / $149.19 / $307.88	Professional		$62.55	$149.19	$307.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.57 / $66.84 / $106.42	Professional	26	$36.57	$66.84	$106.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.98 / $51.89 / $163.52	Professional	TC	$25.98	$51.89	$163.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $52.45 / $89.16	Professional		$52.45	$52.45	$89.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.13 / $280.37 / $434.25	Facility		$144.13	$280.37	$434.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $136.00 / $241.91	Professional		$58.60	$136.00	$241.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $116.00 / $167.92	Professional	26	$34.11	$116.00	$167.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.00 / $24.48 / $105.23	Professional	TC	$20.00	$24.48	$105.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.36 / $43.36 / $43.36	Facility		$43.36	$43.36	$43.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $166.57 / $274.14	Professional		$87.00	$166.57	$274.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.85 / $89.18 / $113.16	Professional	26	$48.85	$89.18	$113.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.84 / $74.45 / $166.64	Professional	TC	$34.84	$74.45	$166.64
Medcost Facility/Professional Facility Modifier Low / Median / High Price $70.75 / $169.13 / $304.33	Facility		$70.75	$169.13	$304.33
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $53.28 / $102.00 / $120.00	Facility	26	$53.28	$102.00	$120.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $43.63 / $43.63 / $43.63	Professional		$43.63	$43.63	$43.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.05 / $52.59 / $92.81	Professional		$30.05	$52.59	$92.81
United Facility/Professional Facility Modifier Low / Median / High Price $123.34 / $1,221.00 / $3,585.00	Facility		$123.34	$1,221.00	$3,585.00
United Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $106.34 / $293.10	Professional		$63.75	$106.34	$293.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.53 / $59.55 / $119.14	Professional	26	$36.53	$59.55	$119.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.74 / $42.19 / $175.22	Professional	TC	$26.74	$42.19	$175.22