Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.10 / $403.07 / $845.06	Facility		$170.10	$403.07	$845.06
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.54 / $6.55 / $11.53	Facility	26	$6.54	$6.55	$11.53
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.35 / $30.65 / $389.87	Facility	TC	$17.35	$30.65	$389.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.80 / $30.26 / $109.20	Professional		$15.80	$30.26	$109.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $8.51 / $35.10	Professional	26	$6.55	$8.51	$35.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.10 / $19.16 / $37.29	Professional	TC	$17.10	$19.16	$37.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $38.11 / $47.22	Professional		$21.74	$38.11	$47.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.77 / $7.75 / $12.91	Professional	26	$5.77	$7.75	$12.91
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $70.83 / $70.83 / $70.83	Professional	50	$70.83	$70.83	$70.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $22.80 / $22.80	Professional	TC	$22.80	$22.80	$22.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.33 / $146.16 / $279.14	Facility		$65.33	$146.16	$279.14
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $49.22 / $65.62 / $408.90	Facility	TC	$49.22	$65.62	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.38 / $34.29 / $58.75	Professional		$26.38	$34.29	$58.75
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $18.50 / $24.40	Professional	26	$7.21	$18.50	$24.40
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.50 / $19.93 / $35.84	Professional	TC	$15.50	$19.93	$35.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $98.70 / $274.29 / $442.75	Facility		$98.70	$274.29	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $34.64 / $60.41	Professional		$25.15	$34.64	$60.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $10.67 / $19.17	Professional	26	$7.38	$10.67	$19.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $24.00 / $41.75	Professional	TC	$18.00	$24.00	$41.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $44.00 / $70.83	Facility		$26.92	$44.00	$70.83
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $14.00 / $24.00	Facility	26	$11.13	$14.00	$24.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $25.80 / $35.90 / $56.26	Facility	TC	$25.80	$35.90	$56.26
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 $28.52 / $28.52 / $28.52	Professional	26	$28.52	$28.52	$28.52
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 $23.26 / $33.56 / $66.06	Professional		$23.26	$33.56	$66.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.27 / $10.08 / $16.46	Professional	26	$7.27	$10.08	$16.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.99 / $23.20 / $39.44	Professional	TC	$15.99	$23.20	$39.44