Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.00 / $248.25 / $442.49	Facility		$134.00	$248.25	$442.49
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.40 / $7.40 / $21.31	Facility	26	$7.40	$7.40	$21.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.91 / $27.16 / $88.58	Facility	TC	$21.91	$27.16	$88.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.51 / $33.50 / $53.00	Professional		$28.51	$33.50	$53.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $10.61 / $32.53	Professional	26	$7.40	$10.61	$32.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $22.87 / $42.00	Professional	TC	$21.00	$22.87	$42.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.66 / $26.66 / $58.21	Professional		$26.66	$26.66	$58.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $8.76 / $14.59	Professional	26	$6.52	$8.76	$14.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.54 / $43.54 / $43.54	Professional	TC	$43.54	$43.54	$43.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.33 / $152.94 / $265.54	Facility		$65.33	$152.94	$265.54
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $56.12 / $74.81 / $408.90	Facility	TC	$56.12	$74.81	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $44.00 / $77.37	Professional		$32.34	$44.00	$77.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $25.50 / $33.76	Professional	26	$8.15	$25.50	$33.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.50 / $24.31 / $42.78	Professional	TC	$18.50	$24.31	$42.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.56 / $319.88 / $534.71	Facility		$124.56	$319.88	$534.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.42 / $45.00 / $74.55	Professional		$32.42	$45.00	$74.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $14.40 / $23.45	Professional	26	$10.39	$14.40	$23.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.86 / $30.29 / $52.06	Professional	TC	$21.86	$30.29	$52.06
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $57.00 / $96.27	Facility		$33.22	$57.00	$96.27
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.83 / $21.00 / $34.65	Facility	26	$15.83	$21.00	$34.65
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $31.38 / $44.07 / $73.42	Facility	TC	$31.38	$44.07	$73.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $127.84 / $127.84 / $127.84	Professional		$127.84	$127.84	$127.84
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $32.24 / $32.24 / $32.24	Professional	26	$32.24	$32.24	$32.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $34.77 / $51.41	Professional		$25.48	$34.77	$51.41
United Facility/Professional Facility Modifier Low / Median / High Price $448.42 / $517.59 / $682.17	Facility		$448.42	$517.59	$682.17
United Facility/Professional Professional Modifier Low / Median / High Price $31.04 / $43.20 / $66.92	Professional		$31.04	$43.20	$66.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $12.57 / $20.73	Professional	26	$9.94	$12.57	$20.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.20 / $27.79 / $48.00	Professional	TC	$20.20	$27.79	$48.00