Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.01 / $290.33 / $518.67	Facility		$81.01	$290.33	$518.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.28 / $6.28 / $11.07	Facility	26	$6.28	$6.28	$11.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.82 / $694.88 / $891.73	Facility	TC	$16.82	$694.88	$891.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $30.16 / $98.80	Professional		$23.10	$30.16	$98.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.28 / $8.16 / $38.36	Professional	26	$6.28	$8.16	$38.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.14 / $79.62 / $320.00	Professional	50	$37.14	$79.62	$320.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.14 / $11.55 / $18.05	Professional	52	$9.14	$11.55	$18.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $18.29 / $36.60	Professional	TC	$16.82	$18.29	$36.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.96 / $27.40 / $45.63	Professional		$23.96	$27.40	$45.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.60 / $7.44 / $12.39	Professional	26	$5.60	$7.44	$12.39
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.24 / $41.10 / $41.10	Professional	50	$38.24	$41.10	$41.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.78 / $42.38 / $42.38	Professional	TC	$15.78	$42.38	$42.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.90 / $152.71 / $263.97	Facility		$80.90	$152.71	$263.97
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $49.20 / $65.59 / $408.90	Facility	TC	$49.20	$65.59	$408.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.62 / $33.29 / $57.31	Professional		$25.62	$33.29	$57.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $17.00 / $23.89	Professional	26	$6.92	$17.00	$23.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $19.41 / $32.90	Professional	TC	$15.00	$19.41	$32.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.66 / $271.91 / $442.75	Facility		$95.66	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.30 / $32.22 / $58.20	Professional		$24.30	$32.22	$58.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $10.28 / $17.18	Professional	26	$7.20	$10.28	$17.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.10 / $23.16 / $41.01	Professional	TC	$17.10	$23.16	$41.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $26.02 / $42.00 / $68.18	Facility		$26.02	$42.00	$68.18
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $11.13 / $14.00 / $22.80	Facility	26	$11.13	$14.00	$22.80
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $24.35 / $38.11 / $58.07	Facility	TC	$24.35	$38.11	$58.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $100.46 / $100.46 / $100.46	Professional		$100.46	$100.46	$100.46
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $27.34 / $27.34 / $27.34	Professional	26	$27.34	$27.34	$27.34
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $150.69 / $150.69 / $150.69	Professional	50	$150.69	$150.69	$150.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $34.60 / $51.41	Professional		$25.48	$34.60	$51.41
United Facility/Professional Professional Modifier Low / Median / High Price $22.31 / $32.33 / $53.65	Professional		$22.31	$32.33	$53.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.27 / $9.27 / $15.85	Professional	26	$7.27	$9.27	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $22.84 / $37.79	Professional	TC	$16.05	$22.84	$37.79