Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.20 / $282.72 / $576.49	Facility		$82.20	$282.72	$576.49
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.40 / $7.40 / $13.04	Facility	26	$7.40	$7.40	$13.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.64 / $27.05 / $129.19	Facility	TC	$21.64	$27.05	$129.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.80 / $31.82 / $84.48	Professional		$14.80	$31.82	$84.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $9.31 / $51.21	Professional	26	$7.40	$9.31	$51.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $78.00 / $96.45 / $126.26	Professional	50	$78.00	$96.45	$126.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $22.53 / $50.63	Professional	TC	$20.96	$22.53	$50.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $46.30 / $57.35	Professional		$26.42	$46.30	$57.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.51 / $8.76 / $14.59	Professional	26	$6.51	$8.76	$14.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $51.66 / $51.66 / $51.66	Professional	50	$51.66	$51.66	$51.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.68 / $33.45 / $42.76	Professional	TC	$25.68	$33.45	$42.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.26 / $162.85 / $263.97	Facility		$81.26	$162.85	$263.97
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $84.15 / $112.20 / $112.20	Facility	TC	$84.15	$112.20	$112.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $45.00 / $79.12	Professional		$32.04	$45.00	$79.12
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $22.00 / $29.68	Professional	26	$8.15	$22.00	$29.68
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $26.28 / $48.09	Professional	TC	$23.00	$26.28	$48.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.95 / $274.29 / $442.75	Facility		$165.95	$274.29	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.48 / $39.93 / $76.36	Professional		$31.48	$39.93	$76.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $11.92 / $21.68	Professional	26	$9.30	$11.92	$21.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.73 / $28.98 / $54.55	Professional	TC	$21.73	$28.98	$54.55
Medcost Facility/Professional Facility Modifier Low / Median / High Price $31.09 / $45.21 / $83.77	Facility		$31.09	$45.21	$83.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.82 / $20.95 / $32.59	Facility	26	$11.82	$20.95	$32.59
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $31.24 / $31.24 / $63.69	Facility	TC	$31.24	$31.24	$63.69
Medcost Facility/Professional Professional Modifier Low / Median / High Price $125.45 / $125.45 / $125.45	Professional		$125.45	$125.45	$125.45
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $188.18 / $188.18 / $188.18	Professional	50	$188.18	$188.18	$188.18
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $93.21 / $93.21 / $93.21	Professional	TC	$93.21	$93.21	$93.21
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 $28.81 / $40.19 / $65.95	Professional		$28.81	$40.19	$65.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.63 / $11.26 / $17.91	Professional	26	$8.63	$11.26	$17.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $27.77 / $48.00	Professional	TC	$19.91	$27.77	$48.00