Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.89 / $288.80 / $560.85	Facility		$71.89	$288.80	$560.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.80 / $6.81 / $11.53	Facility	26	$6.80	$6.81	$11.53
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.76 / $25.28 / $298.89	Facility	TC	$19.76	$25.28	$298.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.92 / $32.51 / $101.70	Professional		$20.92	$32.51	$101.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $7.48 / $21.69	Professional	26	$6.80	$7.48	$21.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $86.52 / $91.97 / $92.31	Professional	50	$86.52	$91.97	$92.31
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.46 / $13.41 / $22.99	Professional	52	$10.46	$13.41	$22.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $21.00 / $39.14	Professional	TC	$18.53	$21.00	$39.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.70 / $30.90 / $51.44	Professional		$23.70	$30.90	$51.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.77 / $7.75 / $12.91	Professional	26	$5.77	$7.75	$12.91
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $46.34 / $46.34 / $77.17	Professional	50	$46.34	$46.34	$77.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.24 / $160.80 / $279.14	Facility		$83.24	$160.80	$279.14
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $49.22 / $65.62 / $408.90	Facility	TC	$49.22	$65.62	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $35.57 / $59.86	Professional		$28.74	$35.57	$59.86
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $18.00 / $24.72	Professional	26	$7.21	$18.00	$24.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $21.53 / $34.69	Professional	TC	$15.00	$21.53	$34.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.87 / $271.91 / $442.75	Facility		$110.87	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $35.67 / $66.30	Professional		$25.77	$35.67	$66.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $10.67 / $18.64	Professional	26	$7.38	$10.67	$18.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $24.79 / $47.64	Professional	TC	$18.14	$24.79	$47.64
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.04 / $42.00 / $75.90	Facility		$28.04	$42.00	$75.90
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.27 / $14.00 / $24.18	Facility	26	$11.27	$14.00	$24.18
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $26.14 / $29.92 / $66.22	Facility	TC	$26.14	$29.92	$66.22
Medcost Facility/Professional Professional Modifier Low / Median / High Price $114.63 / $114.63 / $114.63	Professional		$114.63	$114.63	$114.63
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $28.52 / $28.52	Professional	26	$28.52	$28.52	$28.52
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $171.95 / $171.95 / $171.95	Professional	50	$171.95	$171.95	$171.95
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 $22.94 / $35.36 / $59.76	Professional		$22.94	$35.36	$59.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.27 / $10.08 / $17.20	Professional	26	$7.27	$10.08	$17.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.36 / $23.76 / $43.93	Professional	TC	$16.36	$23.76	$43.93