Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.81 / $400.22 / $576.49	Facility		$93.81	$400.22	$576.49
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.25 / $10.24 / $14.56	Facility	26	$8.25	$10.24	$14.56
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.69 / $370.10 / $547.53	Facility	TC	$18.69	$370.10	$547.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.94 / $34.14 / $80.97	Professional		$26.94	$34.14	$80.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $9.73 / $28.92	Professional	26	$8.26	$9.73	$28.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.69 / $21.01 / $43.69	Professional	TC	$18.69	$21.01	$43.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.49 / $31.97 / $53.23	Professional		$24.49	$31.97	$53.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.26 / $9.77 / $16.29	Professional	26	$7.26	$9.77	$16.29
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 $59.98 / $140.24 / $279.14	Facility		$59.98	$140.24	$279.14
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $55.34 / $73.78 / $408.90	Facility	TC	$55.34	$73.78	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.74 / $44.00 / $78.75	Professional		$29.74	$44.00	$78.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $21.50 / $30.00	Professional	26	$9.10	$21.50	$30.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.64 / $24.75 / $46.39	Professional	TC	$20.64	$24.75	$46.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.30 / $319.88 / $534.71	Facility		$106.30	$319.88	$534.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.74 / $42.90 / $66.59	Professional		$29.74	$42.90	$66.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $14.11 / $22.83	Professional	26	$9.78	$14.11	$22.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.52 / $29.49 / $43.96	Professional	TC	$21.52	$29.49	$43.96
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.84 / $57.00 / $86.36	Facility		$30.84	$57.00	$86.36
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $15.93 / $19.00 / $31.24	Facility	26	$15.93	$19.00	$31.24
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $28.68 / $46.98 / $62.65	Facility	TC	$28.68	$46.98	$62.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $117.39 / $117.39 / $117.39	Professional		$117.39	$117.39	$117.39
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $81.40 / $81.40 / $81.40	Professional	TC	$81.40	$81.40	$81.40
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 $29.10 / $38.54 / $61.40	Professional		$29.10	$38.54	$61.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.56 / $20.87	Professional	26	$9.77	$12.56	$20.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $25.98 / $41.14	Professional	TC	$18.82	$25.98	$41.14