Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.12 / $305.08 / $587.51	Facility		$56.12	$305.08	$587.51
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.18 / $7.40 / $51.33	Facility	26	$5.18	$7.40	$51.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.88 / $298.89 / $447.44	Facility	TC	$13.88	$298.89	$447.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $21.28 / $51.36	Professional		$17.78	$21.28	$51.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $9.10 / $45.35	Professional	26	$7.40	$9.10	$45.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $13.88 / $26.40	Professional	TC	$9.69	$13.88	$26.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.32 / $23.48 / $34.82	Professional		$19.32	$23.48	$34.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $8.64 / $14.59	Professional	26	$6.52	$8.64	$14.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $21.46 / $21.46	Professional	TC	$21.46	$21.46	$21.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.58 / $163.46 / $258.02	Facility		$80.58	$163.46	$258.02
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $75.73 / $100.98 / $100.98	Facility	TC	$75.73	$100.98	$100.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.48 / $33.00 / $55.31	Professional		$23.48	$33.00	$55.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $16.00 / $25.00	Professional	26	$8.15	$16.00	$25.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.33 / $18.39 / $29.89	Professional	TC	$15.33	$18.39	$29.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.93 / $264.39 / $442.75	Facility		$78.93	$264.39	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $26.06 / $56.28	Professional		$19.50	$26.06	$56.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $11.48 / $21.68	Professional	26	$9.27	$11.48	$21.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.21 / $15.19 / $33.75	Professional	TC	$10.21	$15.19	$33.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $21.28 / $27.83 / $50.61	Facility		$21.28	$27.83	$50.61
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.11 / $18.32 / $26.90	Facility	26	$10.11	$18.32	$26.90
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $14.58 / $14.96 / $29.67	Facility	TC	$14.58	$14.96	$29.67
Medcost Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $27.27 / $92.37	Professional		$27.27	$27.27	$92.37
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 / $34.60 / $51.41	Professional		$25.48	$34.60	$51.41
United Facility/Professional Facility Modifier Low / Median / High Price $80.90 / $80.90 / $100.78	Facility		$80.90	$80.90	$100.78
United Facility/Professional Professional Modifier Low / Median / High Price $17.84 / $28.04 / $52.36	Professional		$17.84	$28.04	$52.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.50 / $11.26 / $18.69	Professional	26	$8.50	$11.26	$18.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.25 / $16.55 / $31.51	Professional	TC	$9.25	$16.55	$31.51