Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $251.19 / $446.68	Facility		$39.81	$251.19	$446.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $8.71 / $12.59	Facility	26	$6.76	$8.71	$12.59
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $28.18 / $79.43	Facility	TC	$19.95	$28.18	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $37.15 / $114.82	Professional		$15.85	$37.15	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $11.48 / $37.15	Professional	26	$6.03	$11.48	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $114.82 / $323.59	Professional	50	$35.48	$114.82	$323.59
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $32.36 / $58.88	Professional	52	$17.78	$32.36	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.12 / $51.29	Professional	TC	$18.62	$25.12	$51.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $28.84 / $50.12	Professional		$20.42	$28.84	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.76 / $12.88	Professional	26	$5.75	$7.76	$12.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $21.88 / $48.98	Professional	TC	$17.78	$21.88	$48.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $138.04 / $269.15	Facility		$66.07	$138.04	$269.15
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $44.67 / $58.88 / $426.58	Facility	TC	$44.67	$58.88	$426.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $35.48 / $56.23	Professional		$30.20	$35.48	$56.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.49 / $23.44	Professional	26	$8.13	$13.49	$23.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.44 / $33.88	Professional	TC	$15.14	$23.44	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $234.42 / $446.68	Facility		$23.44	$234.42	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $54.95	Professional		$25.70	$34.67	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.47 / $15.85	Professional	26	$7.41	$10.47	$15.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $24.55 / $39.81	Professional	TC	$18.20	$24.55	$39.81
Medcost Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $15.85 / $15.85	Professional	26	$15.85	$15.85	$15.85
Medcost Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $38.90 / $69.18	Facility		$26.92	$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 $22.91 / $33.11 / $58.88	Professional		$22.91	$33.11	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.12 / $16.22	Professional	26	$7.24	$9.12	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $23.44 / $42.66	Professional	TC	$16.22	$23.44	$42.66