Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $363.08 / $588.84	Facility		$75.86	$363.08	$588.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $9.12 / $12.88	Facility	26	$7.08	$9.12	$12.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $35.48 / $436.52	Facility	TC	$22.91	$35.48	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $38.02 / $114.82	Professional		$12.59	$38.02	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $15.14 / $45.71	Professional	26	$7.08	$15.14	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $104.71 / $338.84	Professional	50	$29.51	$104.71	$338.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.79 / $14.79 / $14.79	Professional	52	$14.79	$14.79	$14.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.90 / $83.18	Professional	TC	$21.88	$38.90	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $29.51 / $57.54	Professional		$22.39	$29.51	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $7.94 / $13.18	Professional	26	$6.31	$7.94	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $42.66 / $81.28	Professional	50	$37.15	$42.66	$81.28
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $39.81	Professional	TC	$18.20	$25.70	$39.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $128.82 / $263.03	Facility		$72.44	$128.82	$263.03
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $61.66 / $426.58	Facility	TC	$46.77	$61.66	$426.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $38.02 / $63.10	Professional		$34.67	$38.02	$63.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $15.49 / $26.92	Professional	26	$8.51	$15.49	$26.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $27.54 / $39.81	Professional	TC	$14.45	$27.54	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $186.21 / $446.68	Facility		$26.92	$186.21	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $39.81 / $61.66	Professional		$28.18	$39.81	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $16.98	Professional	26	$7.94	$10.96	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.54 / $46.77	Professional	TC	$19.95	$27.54	$46.77
Medcost Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $16.98 / $16.98	Professional	26	$16.98	$16.98	$16.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $43.65 / $77.62	Facility		$30.20	$43.65	$77.62
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 $26.30 / $37.15 / $66.07	Professional		$26.30	$37.15	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $16.98	Professional	26	$7.94	$9.77	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.92 / $47.86	Professional	TC	$18.62	$26.92	$47.86