Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $283.36 / $548.72	Facility		$78.37	$283.36	$548.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.84 / $8.85 / $422.15	Facility	26	$8.84	$8.85	$422.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.69 / $296.07 / $453.44	Facility	TC	$18.69	$296.07	$453.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.53 / $32.78 / $129.60	Professional		$27.53	$32.78	$129.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $12.17 / $54.10	Professional	26	$8.85	$12.17	$54.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $20.64 / $44.04	Professional	TC	$17.92	$20.64	$44.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.82 / $32.65 / $54.38	Professional		$25.82	$32.65	$54.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $10.47 / $17.43	Professional	26	$7.79	$10.47	$17.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $28.90 / $36.95	Professional	TC	$17.11	$28.90	$36.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.21 / $161.40 / $265.54	Facility		$89.21	$161.40	$265.54
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 $30.38 / $42.00 / $71.91	Professional		$30.38	$42.00	$71.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $21.50 / $31.12	Professional	26	$9.74	$21.50	$31.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $23.24 / $40.01	Professional	TC	$20.50	$23.24	$40.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.30 / $264.39 / $442.75	Facility		$106.30	$264.39	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.93 / $37.89 / $68.95	Professional		$29.93	$37.89	$68.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $13.73 / $25.92	Professional	26	$11.08	$13.73	$25.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $24.87 / $46.50	Professional	TC	$18.64	$24.87	$46.50
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.62 / $42.73 / $79.43	Facility		$28.62	$42.73	$79.43
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.16 / $18.92 / $32.15	Facility	26	$12.16	$18.92	$32.15
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.89 / $26.89 / $51.36	Facility	TC	$26.89	$26.89	$51.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $37.10 / $37.10 / $119.93	Professional		$37.10	$37.10	$119.93
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $38.53 / $38.53 / $38.53	Professional	26	$38.53	$38.53	$38.53
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 Professional Modifier Low / Median / High Price $27.38 / $37.57 / $62.54	Professional		$27.38	$37.57	$62.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $14.11 / $30.07	Professional	26	$10.28	$14.11	$30.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.10 / $25.00 / $50.12	Professional	TC	$17.10	$25.00	$50.12