Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.20 / $317.80 / $672.08	Facility		$82.20	$317.80	$672.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.80 / $6.81 / $12.01	Facility	26	$6.80	$6.81	$12.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.10 / $276.74 / $891.73	Facility	TC	$21.10	$276.74	$891.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.60 / $33.72 / $120.02	Professional		$13.60	$33.72	$120.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $9.88 / $46.75	Professional	26	$6.81	$9.88	$46.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.45 / $67.39 / $354.00	Professional	50	$16.45	$67.39	$354.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.12 / $13.96 / $15.90	Professional	52	$11.12	$13.96	$15.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $23.16 / $48.73	Professional	TC	$19.46	$23.16	$48.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.17 / $32.79 / $54.61	Professional		$25.17	$32.79	$54.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $8.07 / $13.44	Professional	26	$6.09	$8.07	$13.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.75 / $49.20 / $81.92	Professional	50	$37.75	$49.20	$81.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.20 / $32.20 / $52.49	Professional	TC	$32.20	$32.20	$52.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.96 / $140.51 / $265.54	Facility		$57.96	$140.51	$265.54
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $49.98 / $66.64 / $408.90	Facility	TC	$49.98	$66.64	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $36.75 / $62.01	Professional		$30.51	$36.75	$62.01
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $18.50 / $28.35	Professional	26	$7.51	$18.50	$28.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.50 / $23.12 / $37.47	Professional	TC	$16.50	$23.12	$37.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.47 / $271.91 / $442.75	Facility		$118.47	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.35 / $38.04 / $69.98	Professional		$27.35	$38.04	$69.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $11.21 / $18.64	Professional	26	$7.93	$11.21	$18.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $26.25 / $51.33	Professional	TC	$18.87	$26.25	$51.33
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.60 / $45.00 / $80.52	Facility		$29.60	$45.00	$80.52
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.63 / $15.00 / $25.83	Facility	26	$12.63	$15.00	$25.83
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $28.41 / $41.40 / $70.70	Facility	TC	$28.41	$41.40	$70.70
Medcost Facility/Professional Professional Modifier Low / Median / High Price $121.73 / $121.73 / $121.73	Professional		$121.73	$121.73	$121.73
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $29.70 / $29.70 / $29.70	Professional	26	$29.70	$29.70	$29.70
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $182.60 / $182.60 / $182.60	Professional	50	$182.60	$182.60	$182.60
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 $24.97 / $37.10 / $63.40	Professional		$24.97	$37.10	$63.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $10.37 / $23.13	Professional	26	$7.92	$10.37	$23.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.19 / $27.18 / $47.32	Professional	TC	$17.19	$27.18	$47.32