Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,765.57 / $3,416.00 / $7,669.18	Facility		$2,765.57	$3,416.00	$7,669.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.81 / $68.81 / $68.81	Facility	26	$68.81	$68.81	$68.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.83 / $161.36 / $335.62	Professional		$103.83	$161.36	$335.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $68.81 / $134.11	Professional	26	$48.86	$68.81	$134.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $51.92 / $64.06 / $75.81	Professional	52	$51.92	$64.06	$75.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.32 / $97.34 / $267.08	Professional	TC	$55.32	$97.34	$267.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.91 / $135.52 / $147.63	Professional	26	$53.91	$135.52	$147.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,333.20 / $3,787.56 / $10,505.47	Facility		$1,333.20	$3,787.56	$10,505.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.30 / $542.76 / $821.95	Professional		$135.30	$542.76	$821.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.70 / $125.00 / $184.01	Professional	26	$75.70	$125.00	$184.01
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.59 / $404.00 / $647.03	Professional	TC	$59.59	$404.00	$647.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $424.21 / $9,274.28 / $15,826.73	Facility		$424.21	$9,274.28	$15,826.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.36 / $252.26 / $653.00	Professional		$160.36	$252.26	$653.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.70 / $87.33 / $185.25	Professional	26	$58.70	$87.33	$185.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.91 / $162.03 / $576.00	Professional	TC	$77.91	$162.03	$576.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $141.30 / $467.04 / $835.00	Facility		$141.30	$467.04	$835.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $82.38 / $96.00 / $204.75	Facility	26	$82.38	$96.00	$204.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $547.03 / $547.03 / $547.03	Professional		$547.03	$547.03	$547.03
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $301.36 / $301.36 / $301.36	Professional	26	$301.36	$301.36	$301.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.96 / $102.82 / $170.91	Professional		$57.96	$102.82	$170.91
United Facility/Professional Professional Modifier Low / Median / High Price $155.08 / $217.22 / $555.10	Professional		$155.08	$217.22	$555.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.05 / $85.79 / $156.36	Professional	26	$54.05	$85.79	$156.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.73 / $110.24 / $449.00	Professional	TC	$74.73	$110.24	$449.00