Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.16 / $422.56 / $634.86	Facility		$96.16	$422.56	$634.86
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 $23.51 / $479.09 / $651.04	Facility	TC	$23.51	$479.09	$651.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $42.03 / $131.13	Professional		$32.63	$42.03	$131.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $11.07 / $64.00	Professional	26	$9.11	$11.07	$64.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $26.62 / $52.50	Professional	TC	$23.17	$26.62	$52.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $54.32 / $63.90	Professional		$29.41	$54.32	$63.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $10.79 / $17.97	Professional	26	$8.02	$10.79	$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 $75.02 / $152.94 / $281.68	Facility		$75.02	$152.94	$281.68
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $56.12 / $74.81 / $408.90	Facility	TC	$56.12	$74.81	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.70 / $46.41 / $81.78	Professional		$35.70	$46.41	$81.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $26.00 / $34.09	Professional	26	$10.03	$26.00	$34.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $26.35 / $43.94	Professional	TC	$19.00	$26.35	$43.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.16 / $319.88 / $534.71	Facility		$132.16	$319.88	$534.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.46 / $45.34 / $80.01	Professional		$33.46	$45.34	$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 $24.44 / $31.42 / $55.01	Professional	TC	$24.44	$31.42	$55.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $34.82 / $58.00 / $94.15	Facility		$34.82	$58.00	$94.15
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $16.26 / $22.62 / $33.10	Facility	26	$16.26	$22.62	$33.10
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $32.82 / $50.28 / $76.41	Facility	TC	$32.82	$50.28	$76.41
Medcost Facility/Professional Professional Modifier Low / Median / High Price $142.38 / $142.38 / $142.38	Professional		$142.38	$142.38	$142.38
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 Professional Modifier Low / Median / High Price $33.17 / $44.41 / $73.77	Professional		$33.17	$44.41	$73.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $13.48 / $23.05	Professional	26	$10.28	$13.48	$23.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.89 / $31.13 / $50.72	Professional	TC	$22.89	$31.13	$50.72