Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.51 / $371.86 / $516.62	Facility		$83.51	$371.86	$516.62
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 / $78.84 / $592.14	Facility	TC	$19.50	$78.84	$592.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.53 / $34.40 / $111.52	Professional		$12.53	$34.40	$111.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $9.22 / $45.78	Professional	26	$7.11	$9.22	$45.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $57.19 / $105.64 / $465.40	Professional	50	$57.19	$105.64	$465.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $23.51 / $45.59	Professional	TC	$19.50	$23.51	$45.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.36 / $36.56 / $52.55	Professional		$29.36	$36.56	$52.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $8.42 / $14.02	Professional	26	$6.22	$8.42	$14.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.29 / $47.34 / $47.34	Professional	50	$36.29	$47.34	$47.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.85 / $25.62 / $38.54	Professional	TC	$17.85	$25.62	$38.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.69 / $149.00 / $274.43	Facility		$69.69	$149.00	$274.43
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $52.26 / $69.68 / $408.90	Facility	TC	$52.26	$69.68	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.36 / $38.17 / $67.73	Professional		$29.36	$38.17	$67.73
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $22.00 / $29.24	Professional	26	$7.83	$22.00	$29.24
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $21.53 / $35.18	Professional	TC	$15.00	$21.53	$35.18
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 $29.62 / $38.49 / $65.23	Professional		$29.62	$38.49	$65.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $11.44 / $20.82	Professional	26	$8.01	$11.44	$20.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.95 / $28.42 / $48.57	Professional	TC	$20.95	$28.42	$48.57
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.97 / $49.00 / $83.32	Facility		$29.97	$49.00	$83.32
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $15.00 / $25.84	Facility	26	$12.29	$15.00	$25.84
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $31.22 / $41.68 / $65.34	Facility	TC	$31.22	$41.68	$65.34
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
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $173.88 / $173.88 / $173.88	Professional	50	$173.88	$173.88	$173.88
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 $28.26 / $37.68 / $59.83	Professional		$28.26	$37.68	$59.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $10.51 / $17.14	Professional	26	$7.92	$10.51	$17.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $25.74 / $42.19	Professional	TC	$20.19	$25.74	$42.19