Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.19 / $276.11 / $438.60	Facility		$137.19	$276.11	$438.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.80 / $6.81 / $12.01	Facility	26	$6.80	$6.81	$12.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.07 / $69.09 / $480.84	Facility	TC	$17.07	$69.09	$480.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.02 / $29.90 / $85.00	Professional		$13.02	$29.90	$85.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $7.91 / $41.42	Professional	26	$6.74	$7.91	$41.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $7.51 / $314.00 / $346.00	Professional	50	$7.51	$314.00	$346.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $18.82 / $35.20	Professional	TC	$16.82	$18.82	$35.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $31.39 / $47.22	Professional		$28.36	$31.39	$47.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.01 / $8.07 / $13.44	Professional	26	$6.01	$8.07	$13.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $42.54 / $42.54 / $42.54	Professional	50	$42.54	$42.54	$42.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.65 / $15.65 / $15.65	Professional	TC	$15.65	$15.65	$15.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.56 / $153.33 / $265.54	Facility		$80.56	$153.33	$265.54
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $48.44 / $64.58 / $408.90	Facility	TC	$48.44	$64.58	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.38 / $34.36 / $57.13	Professional		$26.38	$34.36	$57.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $18.00 / $23.76	Professional	26	$7.51	$18.00	$23.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.00 / $19.80 / $33.45	Professional	TC	$16.00	$19.80	$33.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.18 / $271.91 / $442.75	Facility		$97.18	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.16 / $34.32 / $59.67	Professional		$25.16	$34.32	$59.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.14 / $10.16 / $18.64	Professional	26	$7.14	$10.16	$18.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $24.00 / $41.01	Professional	TC	$18.00	$24.00	$41.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $25.62 / $43.00 / $70.31	Facility		$25.62	$43.00	$70.31
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.92 / $13.00 / $23.04	Facility	26	$10.92	$13.00	$23.04
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $25.88 / $34.36 / $57.25	Facility	TC	$25.88	$34.36	$57.25
Medcost Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $104.00 / $104.00	Professional		$104.00	$104.00	$104.00
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $29.70 / $29.70 / $29.70	Professional	26	$29.70	$29.70	$29.70
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $156.00 / $156.00 / $156.00	Professional	50	$156.00	$156.00	$156.00
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 Facility Modifier Low / Median / High Price $80.90 / $80.90 / $100.78	Facility		$80.90	$80.90	$100.78
United Facility/Professional Professional Modifier Low / Median / High Price $23.12 / $33.40 / $55.01	Professional		$23.12	$33.40	$55.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.96 / $16.45	Professional	26	$6.92	$9.96	$16.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.63 / $23.32 / $37.81	Professional	TC	$16.63	$23.32	$37.81