Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.34 / $372.83 / $745.66	Facility		$79.34	$372.83	$745.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.83 / $6.84 / $12.06	Facility	26	$6.83	$6.84	$12.06
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.10 / $298.89 / $865.50	Facility	TC	$21.10	$298.89	$865.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $36.79 / $111.35	Professional		$18.19	$36.79	$111.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $10.81 / $48.97	Professional	26	$6.84	$10.81	$48.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.51 / $86.72 / $288.00	Professional	50	$16.51	$86.72	$288.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.21 / $13.97 / $15.91	Professional	52	$11.21	$13.97	$15.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $25.45 / $50.94	Professional	TC	$21.10	$25.45	$50.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.54 / $38.02 / $54.67	Professional		$30.54	$38.02	$54.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.01 / $8.11 / $13.50	Professional	26	$6.01	$8.11	$13.50
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.77 / $49.25 / $82.00	Professional	50	$37.77	$49.25	$82.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $27.37 / $41.17	Professional	TC	$19.07	$27.37	$41.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.47 / $147.12 / $279.14	Facility		$84.47	$147.12	$279.14
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 $30.54 / $37.72 / $66.42	Professional		$30.54	$37.72	$66.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $20.00 / $26.46	Professional	26	$7.54	$20.00	$26.46
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $23.00 / $35.39	Professional	TC	$15.00	$23.00	$35.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.47 / $271.91 / $442.75	Facility		$118.47	$271.91	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $36.26 / $68.58	Professional		$27.37	$36.26	$68.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $11.21 / $20.04	Professional	26	$7.93	$11.21	$20.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $26.95 / $49.85	Professional	TC	$19.82	$26.95	$49.85
Medcost Facility/Professional Facility Modifier Low / Median / High Price $29.63 / $46.00 / $80.62	Facility		$29.63	$46.00	$80.62
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $12.29 / $17.00 / $25.08	Facility	26	$12.29	$17.00	$25.08
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $29.59 / $43.29 / $67.14	Facility	TC	$29.59	$43.29	$67.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $123.02 / $123.02 / $123.02	Professional		$123.02	$123.02	$123.02
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $29.77 / $29.77 / $29.77	Professional	26	$29.77	$29.77	$29.77
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $184.53 / $184.53 / $184.53	Professional	50	$184.53	$184.53	$184.53
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 $26.11 / $37.72 / $63.23	Professional		$26.11	$37.72	$63.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $10.11 / $17.26	Professional	26	$7.79	$10.11	$17.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $26.59 / $45.97	Professional	TC	$18.80	$26.59	$45.97