Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $331.13 / $691.83	Facility		$50.12	$331.13	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $8.13 / $12.02	Facility	26	$6.61	$8.13	$12.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $29.51 / $389.05	Facility	TC	$19.05	$29.51	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $33.88 / $109.65	Professional		$13.49	$33.88	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $14.13 / $44.67	Professional	26	$6.61	$14.13	$44.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $22.91 / $91.20 / $199.53	Professional	50	$22.91	$91.20	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $67.61	Professional	TC	$19.05	$28.84	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $26.92 / $50.12	Professional		$19.50	$26.92	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $7.59 / $12.59	Professional	26	$5.89	$7.59	$12.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $64.57 / $64.57 / $64.57	Professional	50	$64.57	$64.57	$64.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $33.88	Professional	TC	$15.14	$22.91	$33.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $123.03 / $263.03	Facility		$61.66	$123.03	$263.03
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $44.67 / $60.26 / $426.58	Facility	TC	$44.67	$60.26	$426.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $57.54	Professional		$30.20	$34.67	$57.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.79 / $25.12	Professional	26	$7.76	$14.79	$25.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.44 / $33.11	Professional	TC	$15.85	$23.44	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $190.55 / $446.68	Facility		$23.44	$190.55	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $35.48 / $53.70	Professional		$26.30	$35.48	$53.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.47 / $16.60	Professional	26	$7.41	$10.47	$16.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.99 / $37.15	Professional	TC	$18.20	$23.99	$37.15
Medcost Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $51.29	Professional		$51.29	$51.29	$51.29
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	26	$16.22	$16.22	$16.22
Medcost Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $38.90 / $69.18	Facility		$26.30	$38.90	$69.18
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 $23.44 / $32.36 / $57.54	Professional		$23.44	$32.36	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.55 / $16.22	Professional	26	$7.41	$9.55	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.91 / $40.74	Professional	TC	$15.49	$22.91	$40.74