Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.67 / $373.43 / $606.48	Facility		$81.67	$373.43	$606.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.11 / $7.11 / $12.52	Facility	26	$7.11	$7.11	$12.52
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.98 / $296.07 / $821.80	Facility	TC	$22.98	$296.07	$821.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.04 / $36.40 / $113.75	Professional		$13.04	$36.40	$113.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.11 / $10.25 / $47.30	Professional	26	$7.11	$10.25	$47.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.58 / $104.35 / $350.00	Professional	50	$34.58	$104.35	$350.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.00 / $15.05 / $16.97	Professional	52	$12.00	$15.05	$16.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $26.88 / $55.46	Professional	TC	$21.94	$26.88	$55.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $47.12 / $58.37	Professional		$32.61	$47.12	$58.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.26 / $8.42 / $14.02	Professional	26	$6.26	$8.42	$14.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.58 / $74.42 / $87.56	Professional	50	$52.58	$74.42	$87.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.54 / $29.49 / $44.36	Professional	TC	$20.54	$29.49	$44.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.29 / $153.33 / $281.68	Facility		$82.29	$153.33	$281.68
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $51.51 / $68.68 / $408.90	Facility	TC	$51.51	$68.68	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $38.27 / $66.42	Professional		$32.61	$38.27	$66.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $20.50 / $26.88	Professional	26	$7.83	$20.50	$26.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.50 / $24.78 / $38.07	Professional	TC	$14.50	$24.78	$38.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.60 / $271.91 / $442.75	Facility		$127.60	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.20 / $39.64 / $73.00	Professional		$28.20	$39.64	$73.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $11.44 / $20.82	Professional	26	$8.01	$11.44	$20.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $28.16 / $53.53	Professional	TC	$20.17	$28.16	$53.53
Medcost Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $46.00 / $86.00	Facility		$31.62	$46.00	$86.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $17.00 / $25.84	Facility	26	$12.29	$17.00	$25.84
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $32.07 / $46.95 / $72.98	Facility	TC	$32.07	$46.95	$72.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $131.27 / $131.27 / $131.27	Professional		$131.27	$131.27	$131.27
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $30.95 / $30.95 / $30.95	Professional	26	$30.95	$30.95	$30.95
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $196.90 / $196.90 / $196.90	Professional	50	$196.90	$196.90	$196.90
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 $26.43 / $39.84 / $67.20	Professional		$26.43	$39.84	$67.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.38 / $10.51 / $17.95	Professional	26	$7.38	$10.51	$17.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $29.74 / $49.35	Professional	TC	$19.21	$29.74	$49.35