Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.83 / $376.04 / $615.03	Facility		$97.83	$376.04	$615.03
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 $26.19 / $292.91 / $592.14	Facility	TC	$26.19	$292.91	$592.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.20 / $40.56 / $141.93	Professional		$14.20	$40.56	$141.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $10.17 / $45.90	Professional	26	$7.11	$10.17	$45.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $8.06 / $104.70 / $358.00	Professional	50	$8.06	$104.70	$358.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $29.57 / $63.22	Professional	TC	$25.37	$29.57	$63.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $53.52 / $66.30	Professional		$37.04	$53.52	$66.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.26 / $8.42 / $14.02	Professional	26	$6.26	$8.42	$14.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.84 / $59.73 / $99.45	Professional	50	$45.84	$59.73	$99.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.21 / $32.13 / $52.29	Professional	TC	$24.21	$32.13	$52.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.22 / $145.72 / $274.43	Facility		$69.22	$145.72	$274.43
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $51.51 / $68.68 / $408.90	Facility	TC	$51.51	$68.68	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $41.70 / $66.42	Professional		$35.00	$41.70	$66.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $20.00 / $26.98	Professional	26	$7.83	$20.00	$26.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $29.21 / $42.67	Professional	TC	$15.00	$29.21	$42.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $150.41 / $271.91 / $442.75	Facility		$150.41	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.66 / $41.08 / $73.43	Professional		$28.66	$41.08	$73.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $11.59 / $20.82	Professional	26	$8.01	$11.59	$20.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.55 / $31.68 / $61.64	Professional	TC	$21.55	$31.68	$61.64
Medcost Facility/Professional Facility Modifier Low / Median / High Price $35.88 / $47.38 / $96.06	Facility		$35.88	$47.38	$96.06
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.15 / $15.00 / $25.84	Facility	26	$12.15	$15.00	$25.84
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $33.33 / $53.28 / $85.58	Facility	TC	$33.33	$53.28	$85.58
Medcost Facility/Professional Professional Modifier Low / Median / High Price $145.47 / $145.47 / $145.47	Professional		$145.47	$145.47	$145.47
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 $218.21 / $218.21 / $218.21	Professional	50	$218.21	$218.21	$218.21
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 $28.93 / $43.26 / $74.75	Professional		$28.93	$43.26	$74.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $10.38 / $17.94	Professional	26	$7.92	$10.38	$17.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $31.63 / $56.84	Professional	TC	$21.94	$31.63	$56.84