Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $288.40 / $630.96	Facility		$53.70	$288.40	$630.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $9.33 / $13.49	Facility	26	$7.41	$9.33	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $33.88 / $125.89	Facility	TC	$21.88	$33.88	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $33.11 / $107.15	Professional		$8.51	$33.11	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.79 / $47.86	Professional	26	$7.08	$14.79	$47.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $95.50 / $177.83	Professional	50	$38.90	$95.50	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.92 / $61.66	Professional	TC	$20.89	$26.92	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.18 / $53.70	Professional		$23.44	$28.18	$53.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.51 / $13.80	Professional	26	$6.61	$8.51	$13.80
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $41.69 / $54.95	Professional	50	$41.69	$41.69	$54.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $25.12 / $34.67	Professional	TC	$22.39	$25.12	$34.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $144.54 / $251.19	Facility		$77.62	$144.54	$251.19
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $91.20 / $91.20 / $123.03	Facility	TC	$91.20	$91.20	$123.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $75.86	Professional		$34.67	$44.67	$75.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $18.62 / $28.18	Professional	26	$8.71	$18.62	$28.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $26.92 / $43.65	Professional	TC	$22.91	$26.92	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $173.78 / $446.68	Facility		$26.30	$173.78	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $39.81 / $60.26	Professional		$30.90	$39.81	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.48 / $18.62	Professional	26	$8.32	$11.48	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $43.65	Professional	TC	$21.88	$28.18	$43.65
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $40.74 / $74.13	Facility		$28.84	$40.74	$74.13
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 $81.28 / $363.08 / $562.34	Facility		$81.28	$363.08	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $64.57	Professional		$28.84	$37.15	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.72 / $18.20	Professional	26	$8.71	$10.72	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.30 / $47.86	Professional	TC	$19.95	$26.30	$47.86