Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $380.19 / $794.33	Facility		$67.61	$380.19	$794.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $9.77 / $14.13	Facility	26	$7.59	$9.77	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $39.81 / $426.58	Facility	TC	$20.42	$39.81	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $36.31 / $125.89	Professional		$9.12	$36.31	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $47.86	Professional	26	$7.94	$14.13	$47.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $70.79 / $316.23	Professional	50	$32.36	$70.79	$316.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $35.48 / $87.10	Professional	TC	$20.42	$35.48	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $27.54 / $52.48	Professional		$21.38	$27.54	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.32 / $14.13	Professional	26	$6.92	$8.32	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $43.65 / $70.79	Professional	50	$33.11	$43.65	$70.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $24.55 / $40.74	Professional	TC	$16.98	$24.55	$40.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $128.82 / $263.03	Facility		$79.43	$128.82	$263.03
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $63.10 / $426.58	Facility	TC	$46.77	$63.10	$426.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $38.90 / $64.57	Professional		$33.88	$38.90	$64.57
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $18.20 / $26.92	Professional	26	$9.12	$18.20	$26.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.70 / $37.15	Professional	TC	$17.38	$25.70	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $181.97 / $446.68	Facility		$25.12	$181.97	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $38.02 / $58.88	Professional		$28.18	$38.02	$58.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.75 / $18.62	Professional	26	$8.51	$11.75	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $25.70 / $40.74	Professional	TC	$19.50	$25.70	$40.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	26	$19.50	$19.50	$19.50
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $42.66 / $75.86	Facility		$28.84	$42.66	$75.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $363.08 / $562.34	Facility		$81.28	$363.08	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $35.48 / $63.10	Professional		$25.70	$35.48	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.47 / $19.05	Professional	26	$8.51	$10.47	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $24.55 / $42.66	Professional	TC	$16.98	$24.55	$42.66