Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.09 / $340.03 / $573.34	Facility		$79.09	$340.03	$573.34
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 Facility Modifier TC Low / Median / High Price $23.23 / $152.46 / $445.86	Facility	TC	$23.23	$152.46	$445.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.35 / $39.89 / $134.46	Professional		$32.35	$39.89	$134.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.07 / $52.80	Professional	26	$9.11	$11.07	$52.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $26.41 / $43.80	Professional	TC	$23.23	$26.41	$43.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.70 / $54.32 / $63.90	Professional		$35.70	$54.32	$63.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $11.37 / $17.97	Professional	26	$8.02	$11.37	$17.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $39.04 / $45.93	Professional	TC	$21.27	$39.04	$45.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.66 / $162.85 / $284.63	Facility		$70.66	$162.85	$284.63
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $53.05 / $70.73 / $408.90	Facility	TC	$53.05	$70.73	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.70 / $44.10 / $76.19	Professional		$35.70	$44.10	$76.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $23.00 / $32.94	Professional	26	$10.03	$23.00	$32.94
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $25.66 / $41.64	Professional	TC	$19.00	$25.66	$41.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.16 / $271.91 / $442.75	Facility		$132.16	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $43.00 / $80.01	Professional		$31.89	$43.00	$80.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $14.70 / $25.00	Professional	26	$10.25	$14.70	$25.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.89 / $29.26 / $55.01	Professional	TC	$22.89	$29.26	$55.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $34.61 / $54.00 / $93.37	Facility		$34.61	$54.00	$93.37
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.02 / $19.00 / $33.13	Facility	26	$16.02	$19.00	$33.13
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $33.44 / $46.76 / $74.06	Facility	TC	$33.44	$46.76	$74.06
Medcost Facility/Professional Professional Modifier Low / Median / High Price $141.19 / $141.19 / $141.19	Professional		$141.19	$141.19	$141.19
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $39.71 / $39.71 / $39.71	Professional	26	$39.71	$39.71	$39.71
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 / $100.78	Facility		$80.90	$80.90	$100.78
United Facility/Professional Professional Modifier Low / Median / High Price $31.60 / $43.66 / $73.48	Professional		$31.60	$43.66	$73.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $13.48 / $21.95	Professional	26	$10.28	$13.48	$21.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $30.13 / $50.72	Professional	TC	$21.32	$30.13	$50.72