Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.60 / $384.83 / $786.38	Facility		$83.60	$384.83	$786.38
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 $22.98 / $287.19 / $763.58	Facility	TC	$22.98	$287.19	$763.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $35.81 / $119.32	Professional		$15.09	$35.81	$119.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $10.17 / $44.82	Professional	26	$7.11	$10.17	$44.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.06 / $72.62 / $372.00	Professional	50	$25.06	$72.62	$372.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $26.50 / $67.08	Professional	TC	$21.64	$26.50	$67.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.49 / $50.96 / $59.95	Professional		$33.49	$50.96	$59.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.26 / $8.61 / $14.02	Professional	26	$6.26	$8.61	$14.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.44 / $54.00 / $89.92	Professional	50	$41.44	$54.00	$89.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $28.23 / $45.93	Professional	TC	$21.27	$28.23	$45.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $147.94 / $281.68	Facility		$78.37	$147.94	$281.68
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 $33.49 / $38.04 / $67.50	Professional		$33.49	$38.04	$67.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $19.50 / $25.92	Professional	26	$7.83	$19.50	$25.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.50 / $25.66 / $38.97	Professional	TC	$15.50	$25.66	$38.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.16 / $271.91 / $442.75	Facility		$132.16	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.25 / $39.15 / $73.00	Professional		$28.25	$39.15	$73.00
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 $20.17 / $27.57 / $53.53	Professional	TC	$20.17	$27.57	$53.53
Medcost Facility/Professional Facility Modifier Low / Median / High Price $31.82 / $46.00 / $86.80	Facility		$31.82	$46.00	$86.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $15.00 / $25.08	Facility	26	$12.29	$15.00	$25.08
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $31.00 / $47.72 / $72.09	Facility	TC	$31.00	$47.72	$72.09
Medcost Facility/Professional Professional Modifier Low / Median / High Price $130.09 / $130.09 / $130.09	Professional		$130.09	$130.09	$130.09
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $195.13 / $195.13 / $195.13	Professional	50	$195.13	$195.13	$195.13
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $99.14 / $99.14 / $99.14	Professional	TC	$99.14	$99.14	$99.14
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 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 $26.43 / $38.93 / $67.30	Professional		$26.43	$38.93	$67.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $10.81 / $17.14	Professional	26	$7.93	$10.81	$17.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $27.43 / $49.35	Professional	TC	$19.11	$27.43	$49.35