Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $319.20 / $657.90 / $793.10	Facility		$319.20	$657.90	$793.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.16 / $13.16 / $22.43	Facility	26	$13.16	$13.16	$22.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.78 / $86.48 / $185.93	Professional		$69.78	$86.48	$185.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $14.48 / $129.35	Professional	26	$13.16	$14.48	$129.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.99 / $71.97 / $105.33	Professional	TC	$59.99	$71.97	$105.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $11.72 / $15.57	Professional	26	$11.72	$11.72	$15.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.55 / $528.54 / $1,008.95	Facility		$221.55	$528.54	$1,008.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.64 / $101.92 / $169.33	Professional		$90.64	$101.92	$169.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.48 / $45.01 / $57.82	Professional	26	$14.48	$45.01	$57.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.50 / $76.16 / $119.24	Professional	TC	$45.50	$76.16	$119.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $392.24 / $752.99 / $1,215.45	Facility		$392.24	$752.99	$1,215.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.38 / $107.00 / $203.83	Professional		$79.38	$107.00	$203.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $21.49 / $36.14	Professional	26	$15.47	$21.49	$36.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.91 / $85.71 / $167.29	Professional	TC	$63.91	$85.71	$167.29
Medcost Facility/Professional Facility Modifier Low / Median / High Price $86.36 / $121.00 / $243.10	Facility		$86.36	$121.00	$243.10
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $24.56 / $28.00 / $50.54	Facility	26	$24.56	$28.00	$50.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $378.56 / $378.56 / $378.56	Professional		$378.56	$378.56	$378.56
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $56.08 / $56.08 / $56.08	Professional	26	$56.08	$56.08	$56.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.46 / $104.33 / $154.23	Professional		$76.46	$104.33	$154.23
United Facility/Professional Facility Modifier Low / Median / High Price $177.91 / $179.52 / $230.13	Facility		$177.91	$179.52	$230.13
United Facility/Professional Professional Modifier Low / Median / High Price $76.15 / $106.98 / $187.93	Professional		$76.15	$106.98	$187.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.45 / $33.32	Professional	26	$14.45	$19.45	$33.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.78 / $86.87 / $154.61	Professional	TC	$61.78	$86.87	$154.61