Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $269.15 / $501.19	Facility		$77.62	$269.15	$501.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $10.96 / $28.84	Facility	26	$8.91	$10.96	$28.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.62 / $61.66 / $426.58	Facility	TC	$18.62	$61.66	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $47.86 / $138.04	Professional		$26.92	$47.86	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $53.70	Professional	26	$8.91	$12.02	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $66.07	Professional	TC	$18.20	$25.70	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.30 / $50.12	Professional		$20.89	$26.30	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.77 / $14.79	Professional	26	$7.76	$9.77	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $19.95 / $33.11	Professional	TC	$14.45	$19.95	$33.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $151.36 / $263.03	Facility		$79.43	$151.36	$263.03
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $83.18 / $83.18 / $109.65	Facility	TC	$83.18	$83.18	$109.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $72.44	Professional		$32.36	$41.69	$72.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $19.50 / $30.90	Professional	26	$10.23	$19.50	$30.90
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $22.91 / $37.15	Professional	TC	$20.42	$22.91	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $165.96 / $446.68	Facility		$22.39	$165.96	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $57.54	Professional		$28.84	$37.15	$57.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.18 / $21.38	Professional	26	$10.00	$13.18	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.99 / $37.15	Professional	TC	$18.62	$23.99	$37.15
Medcost Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $38.02 / $72.44	Facility		$27.54	$38.02	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $363.08 / $562.34	Facility		$81.28	$363.08	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $35.48 / $61.66	Professional		$27.54	$35.48	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.59 / $21.38	Professional	26	$10.23	$12.59	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.39 / $41.69	Professional	TC	$16.98	$22.39	$41.69