Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.45 / $301.83 / $500.47	Facility		$68.45	$301.83	$500.47
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 $19.50 / $34.44 / $410.90	Facility	TC	$19.50	$34.44	$410.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $31.53 / $72.47	Professional		$26.46	$31.53	$72.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $7.78 / $17.16	Professional	26	$7.11	$7.78	$17.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.03 / $21.53 / $39.65	Professional	TC	$19.03	$21.53	$39.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.20 / $31.56 / $52.55	Professional		$24.20	$31.56	$52.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $7.83 / $14.02	Professional	26	$6.25	$7.83	$14.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.14 / $25.62 / $38.54	Professional	TC	$23.14	$25.62	$38.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.77 / $154.21 / $265.54	Facility		$58.77	$154.21	$265.54
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $53.81 / $71.73 / $408.90	Facility	TC	$53.81	$71.73	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.50 / $37.00 / $64.68	Professional		$18.50	$37.00	$64.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $10.18 / $25.48	Professional	26	$7.83	$10.18	$25.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.53 / $24.14 / $50.00	Professional	TC	$21.53	$24.14	$50.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.87 / $271.91 / $442.75	Facility		$110.87	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $38.00 / $65.64	Professional		$27.45	$38.00	$65.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $11.44 / $19.47	Professional	26	$8.01	$11.44	$19.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.47 / $26.91 / $46.17	Professional	TC	$19.47	$26.91	$46.17
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.97 / $49.00 / $76.76	Facility		$29.97	$49.00	$76.76
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $15.00 / $25.08	Facility	26	$12.29	$15.00	$25.08
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $41.68 / $62.19	Facility	TC	$27.22	$41.68	$62.19
Medcost Facility/Professional Professional Modifier Low / Median / High Price $115.92 / $115.92 / $115.92	Professional		$115.92	$115.92	$115.92
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 / $34.77 / $51.41	Professional		$25.48	$34.77	$51.41
United Facility/Professional Professional Modifier Low / Median / High Price $25.16 / $36.34 / $60.51	Professional		$25.16	$36.34	$60.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $10.82 / $17.14	Professional	26	$7.92	$10.82	$17.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.51 / $25.14 / $42.57	Professional	TC	$17.51	$25.14	$42.57