Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.34 / $324.64 / $583.10	Facility		$79.34	$324.64	$583.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.40 / $7.40 / $13.04	Facility	26	$7.40	$7.40	$13.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.07 / $69.09 / $410.90	Facility	TC	$17.07	$69.09	$410.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $28.11 / $99.45	Professional		$24.48	$28.11	$99.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $10.19 / $47.60	Professional	26	$7.40	$10.19	$47.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $18.46 / $36.72	Professional	TC	$16.60	$18.46	$36.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.26 / $27.56 / $41.11	Professional		$22.26	$27.56	$41.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $8.76 / $14.59	Professional	26	$6.52	$8.76	$14.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.65 / $26.42 / $33.78	Professional	TC	$15.65	$26.42	$33.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.23 / $159.56 / $263.97	Facility		$71.23	$159.56	$263.97
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $75.73 / $100.98 / $100.98	Facility	TC	$75.73	$100.98	$100.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.02 / $36.00 / $63.30	Professional		$27.02	$36.00	$63.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $19.50 / $27.17	Professional	26	$8.15	$19.50	$27.17
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.50 / $19.80 / $33.76	Professional	TC	$16.50	$19.80	$33.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.13 / $264.39 / $442.75	Facility		$133.13	$264.39	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $33.72 / $61.29	Professional		$26.69	$33.72	$61.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $11.48 / $21.68	Professional	26	$9.27	$11.48	$21.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $23.05 / $43.28	Professional	TC	$17.28	$23.05	$43.28
Medcost Facility/Professional Facility Modifier Low / Median / High Price $24.49 / $38.15 / $60.52	Facility		$24.49	$38.15	$60.52
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $10.11 / $15.83 / $26.90	Facility	26	$10.11	$15.83	$26.90
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $24.91 / $24.91 / $46.78	Facility	TC	$24.91	$24.91	$46.78
Medcost Facility/Professional Professional Modifier Low / Median / High Price $107.75 / $107.75 / $107.75	Professional		$107.75	$107.75	$107.75
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $32.24 / $32.24 / $32.24	Professional	26	$32.24	$32.24	$32.24
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 Professional Modifier Low / Median / High Price $24.42 / $34.04 / $54.86	Professional		$24.42	$34.04	$54.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $11.26 / $25.15	Professional	26	$8.53	$11.26	$25.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.84 / $22.79 / $37.82	Professional	TC	$15.84	$22.79	$37.82