Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.36 / $313.13 / $643.12	Facility		$91.36	$313.13	$643.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.80 / $6.81 / $11.53	Facility	26	$6.80	$6.81	$11.53
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.50 / $34.44 / $821.80	Facility	TC	$19.50	$34.44	$821.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $31.25 / $70.01	Professional		$15.09	$31.25	$70.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $8.85 / $45.78	Professional	26	$6.81	$8.85	$45.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $21.26 / $40.20	Professional	TC	$18.82	$21.26	$40.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $30.90 / $51.44	Professional		$28.74	$30.90	$51.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.77 / $7.64 / $12.91	Professional	26	$5.77	$7.64	$12.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.85 / $17.85 / $25.62	Professional	TC	$17.85	$17.85	$25.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.31 / $154.21 / $277.39	Facility		$67.31	$154.21	$277.39
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $49.98 / $66.64 / $408.90	Facility	TC	$49.98	$66.64	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $37.36 / $62.26	Professional		$28.74	$37.36	$62.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $19.00 / $25.48	Professional	26	$7.21	$19.00	$25.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $22.61 / $37.50	Professional	TC	$18.00	$22.61	$37.50
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 / $37.84 / $65.56	Professional		$27.45	$37.84	$65.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $11.17 / $18.79	Professional	26	$7.93	$11.17	$18.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $26.85 / $46.91	Professional	TC	$19.21	$26.85	$46.91
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.24 / $49.00 / $76.19	Facility		$28.24	$49.00	$76.19
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.63 / $15.00 / $24.78	Facility	26	$12.63	$15.00	$24.78
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.39 / $41.68 / $65.34	Facility	TC	$26.39	$41.68	$65.34
Medcost Facility/Professional Professional Modifier Low / Median / High Price $113.45 / $113.45 / $113.45	Professional		$113.45	$113.45	$113.45
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $28.52 / $28.52	Professional	26	$28.52	$28.52	$28.52
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 $24.85 / $35.78 / $60.34	Professional		$24.85	$35.78	$60.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.68 / $9.94 / $15.68	Professional	26	$7.68	$9.94	$15.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.26 / $24.70 / $42.34	Professional	TC	$17.26	$24.70	$42.34