Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.69 / $488.43 / $1,037.55	Facility		$95.69	$488.43	$1,037.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.11 / $9.11 / $16.05	Facility	26	$9.11	$9.11	$16.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.57 / $43.42 / $985.20	Facility	TC	$24.57	$43.42	$985.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.70 / $39.03 / $109.06	Professional		$33.70	$39.03	$109.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $10.36 / $31.85	Professional	26	$9.11	$10.36	$31.85
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $213.20 / $266.89 / $278.80	Professional	50	$213.20	$266.89	$278.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.27 / $25.76 / $56.82	Professional	TC	$24.27	$25.76	$56.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $39.97 / $66.55	Professional		$37.18	$39.97	$66.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $10.63 / $17.97	Professional	26	$7.97	$10.63	$17.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $38.00 / $41.29	Professional	TC	$32.29	$38.00	$41.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $129.85 / $260.31 / $426.10	Facility		$129.85	$260.31	$426.10
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $140.00 / $186.66 / $186.66	Facility	TC	$140.00	$186.66	$186.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $49.00 / $86.25	Professional		$37.18	$49.00	$86.25
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $22.00 / $31.85	Professional	26	$10.03	$22.00	$31.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.00 / $29.85 / $55.00	Professional	TC	$27.00	$29.85	$55.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.52 / $331.26 / $534.71	Facility		$188.52	$331.26	$534.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $47.84 / $87.87	Professional		$37.72	$47.84	$87.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $14.69 / $26.70	Professional	26	$11.44	$14.69	$26.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.52 / $33.92 / $61.00	Professional	TC	$26.52	$33.92	$61.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $35.97 / $55.20 / $97.18	Facility		$35.97	$55.20	$97.18
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.58 / $24.91 / $39.90	Facility	26	$12.58	$24.91	$39.90
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $38.10 / $38.10 / $70.59	Facility	TC	$38.10	$38.10	$70.59
Medcost Facility/Professional Professional Modifier Low / Median / High Price $147.09 / $147.09 / $147.09	Professional		$147.09	$147.09	$147.09
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $220.63 / $220.63 / $220.63	Professional	50	$220.63	$220.63	$220.63
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $107.42 / $107.42 / $107.42	Professional	TC	$107.42	$107.42	$107.42
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 $35.21 / $48.50 / $76.80	Professional		$35.21	$48.50	$76.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.87 / $14.86 / $21.95	Professional	26	$10.87	$14.86	$21.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $33.20 / $54.12	Professional	TC	$24.30	$33.20	$54.12