Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.16 / $270.35 / $491.65	Facility		$78.16	$270.35	$491.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.11 / $9.11 / $16.05	Facility	26	$9.11	$9.11	$16.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.41 / $32.22 / $72.95	Professional		$23.41	$32.22	$72.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $10.03 / $28.92	Professional	26	$9.11	$10.03	$28.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $22.51 / $45.36	Professional	TC	$19.76	$22.51	$45.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.52 / $35.52 / $50.27	Professional		$35.52	$35.52	$50.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $10.03 / $17.97	Professional	26	$8.02	$10.03	$17.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $24.73 / $34.99	Professional	TC	$19.55	$24.73	$34.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.17 / $153.33 / $265.54	Facility		$74.17	$153.33	$265.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $41.62 / $72.56	Professional		$33.04	$41.62	$72.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $22.50 / $31.96	Professional	26	$10.03	$22.50	$31.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.50 / $23.26 / $40.47	Professional	TC	$17.50	$23.26	$40.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.47 / $274.29 / $442.75	Facility		$118.47	$274.29	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $41.96 / $74.84	Professional		$30.86	$41.96	$74.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $14.66 / $25.00	Professional	26	$9.96	$14.66	$25.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.00 / $27.84 / $49.85	Professional	TC	$20.00	$27.84	$49.85
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.24 / $52.00 / $87.18	Facility		$33.24	$52.00	$87.18
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.93 / $19.00 / $33.10	Facility	26	$15.93	$19.00	$33.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $131.74 / $131.74 / $131.74	Professional		$131.74	$131.74	$131.74
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $92.04 / $92.04 / $92.04	Professional	TC	$92.04	$92.04	$92.04
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 $80.90 / $80.90 / $80.90	Facility		$80.90	$80.90	$80.90
United Facility/Professional Professional Modifier Low / Median / High Price $28.16 / $39.92 / $68.00	Professional		$28.16	$39.92	$68.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $13.86 / $30.13	Professional	26	$10.28	$13.86	$30.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.88 / $26.59 / $45.97	Professional	TC	$17.88	$26.59	$45.97