Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.01 / $382.46 / $770.65	Facility		$81.01	$382.46	$770.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $9.51 / $13.51	Facility	26	$7.66	$9.51	$13.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.57 / $363.96 / $704.54	Facility	TC	$20.57	$363.96	$704.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.39 / $34.51 / $145.60	Professional		$17.39	$34.51	$145.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $10.17 / $52.29	Professional	26	$7.67	$10.17	$52.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.20 / $86.02 / $448.00	Professional	50	$48.20	$86.02	$448.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $23.67 / $60.12	Professional	TC	$19.14	$23.67	$60.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.16 / $45.03 / $55.78	Professional		$31.16	$45.03	$55.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.75 / $9.08 / $15.13	Professional	26	$6.75	$9.08	$15.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.52 / $50.25 / $83.66	Professional	50	$38.52	$50.25	$83.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $31.79 / $60.98	Professional	TC	$18.82	$31.79	$60.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.46 / $152.71 / $279.14	Facility		$88.46	$152.71	$279.14
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $52.29 / $69.72 / $408.90	Facility	TC	$52.29	$69.72	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.16 / $39.90 / $68.92	Professional		$31.16	$39.90	$68.92
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $20.50 / $27.44	Professional	26	$8.44	$20.50	$27.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.50 / $22.95 / $40.47	Professional	TC	$17.50	$22.95	$40.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.95 / $271.91 / $442.75	Facility		$116.95	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $38.84 / $69.11	Professional		$27.43	$38.84	$69.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $12.15 / $22.47	Professional	26	$8.55	$12.15	$22.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.67 / $27.00 / $48.38	Professional	TC	$19.67	$27.00	$48.38
Medcost Facility/Professional Facility Modifier Low / Median / High Price $31.06 / $49.00 / $81.96	Facility		$31.06	$49.00	$81.96
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.67 / $16.00 / $27.88	Facility	26	$13.67	$16.00	$27.88
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $28.71 / $43.28 / $65.17	Facility	TC	$28.71	$43.28	$65.17
Medcost Facility/Professional Professional Modifier Low / Median / High Price $123.10 / $123.10 / $123.10	Professional		$123.10	$123.10	$123.10
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $184.64 / $184.64 / $184.64	Professional	50	$184.64	$184.64	$184.64
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $89.68 / $89.68 / $89.68	Professional	TC	$89.68	$89.68	$89.68
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 $25.84 / $40.27 / $64.73	Professional		$25.84	$40.27	$64.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $11.20 / $18.51	Professional	26	$8.59	$11.20	$18.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $25.80 / $43.43	Professional	TC	$17.48	$25.80	$43.43