Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $398.11 / $1,047.13	Facility		$48.98	$398.11	$1,047.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $9.12 / $16.60	Facility	26	$8.91	$9.12	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $45.71 / $109.65	Facility	TC	$24.55	$45.71	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $114.82	Professional		$33.11	$46.77	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $34.67	Professional	26	$8.91	$12.02	$34.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $204.17 / $281.84	Professional	50	$56.23	$204.17	$281.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	52	$17.78	$17.78	$17.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.90 / $60.26	Professional	TC	$23.99	$30.90	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $35.48 / $67.61	Professional		$26.30	$35.48	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $13.49	Professional	26	$7.94	$9.77	$13.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $52.48 / $52.48	Professional	50	$52.48	$52.48	$52.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $40.74	Professional	TC	$21.88	$28.84	$40.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $239.88 / $416.87	Facility		$120.23	$239.88	$416.87
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $151.36 / $151.36 / $204.17	Facility	TC	$151.36	$151.36	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $48.98 / $87.10	Professional		$40.74	$48.98	$87.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $19.95 / $29.51	Professional	26	$10.72	$19.95	$29.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $30.90 / $45.71	Professional	TC	$26.92	$30.90	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $281.84 / $537.03	Facility		$29.51	$281.84	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $72.44	Professional		$37.15	$46.77	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.13 / $22.91	Professional	26	$10.23	$14.13	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $33.11 / $50.12	Professional	TC	$26.30	$33.11	$50.12
Medcost Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $47.86 / $89.13	Facility		$33.88	$47.86	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $436.52 / $660.69	Facility		$109.65	$436.52	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $44.67 / $75.86	Professional		$35.48	$44.67	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.18 / $22.39	Professional	26	$10.72	$13.18	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $31.62 / $53.70	Professional	TC	$24.55	$31.62	$53.70