Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.18 / $284.99 / $685.51	Facility		$57.18	$284.99	$685.51
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.11 / $7.11 / $12.52	Facility	26	$7.11	$7.11	$12.52
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.75 / $27.82 / $492.60	Facility	TC	$15.75	$27.82	$492.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.85 / $28.05 / $62.63	Professional		$22.85	$28.05	$62.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $8.77 / $50.40	Professional	26	$7.11	$8.77	$50.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.75 / $18.10 / $36.76	Professional	TC	$15.75	$18.10	$36.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.78 / $27.11 / $44.14	Professional		$20.78	$27.11	$44.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.26 / $8.42 / $14.02	Professional	26	$6.26	$8.42	$14.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.35 / $24.35 / $24.35	Professional	TC	$24.35	$24.35	$24.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.42 / $133.47 / $252.84	Facility		$44.42	$133.47	$252.84
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $49.22 / $65.62 / $408.90	Facility	TC	$49.22	$65.62	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.22 / $35.31 / $58.75	Professional		$25.22	$35.31	$58.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $19.00 / $28.82	Professional	26	$7.83	$19.00	$28.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.00 / $19.20 / $35.00	Professional	TC	$16.00	$19.20	$35.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.57 / $319.88 / $534.71	Facility		$89.57	$319.88	$534.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.68 / $35.75 / $59.74	Professional		$24.68	$35.75	$59.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $11.64 / $20.25	Professional	26	$8.01	$11.64	$20.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.75 / $25.06 / $40.28	Professional	TC	$16.75	$25.06	$40.28
Medcost Facility/Professional Facility Modifier Low / Median / High Price $26.15 / $45.00 / $71.77	Facility		$26.15	$45.00	$71.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.63 / $15.00 / $25.83	Facility	26	$12.63	$15.00	$25.83
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $22.31 / $33.67 / $74.13	Facility	TC	$22.31	$33.67	$74.13
Medcost Facility/Professional Professional Modifier Low / Median / High Price $99.36 / $99.36 / $99.36	Professional		$99.36	$99.36	$99.36
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $30.95 / $30.95 / $30.95	Professional	26	$30.95	$30.95	$30.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $34.60 / $51.41	Professional		$25.48	$34.60	$51.41
United Facility/Professional Professional Modifier Low / Median / High Price $22.84 / $32.59 / $54.85	Professional		$22.84	$32.59	$54.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $10.51 / $17.14	Professional	26	$7.92	$10.51	$17.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.28 / $22.83 / $37.13	Professional	TC	$15.28	$22.83	$37.13