Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $371.54 / $478.63	Facility		$204.17	$371.54	$478.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Facility	26	$25.12	$25.12	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $72.44 / $162.18	Professional		$40.74	$72.44	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $42.66 / $181.97	Professional	26	$25.12	$42.66	$181.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.79 / $151.36 / $354.81	Professional	50	$70.79	$151.36	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $21.88 / $50.12	Professional	TC	$14.13	$21.88	$50.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $43.65 / $85.11	Professional		$34.67	$43.65	$85.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $32.36 / $50.12	Professional	26	$28.18	$32.36	$50.12
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $53.70 / $70.79 / $141.25	Professional	50	$53.70	$70.79	$141.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $302.00 / $537.03	Facility		$162.18	$302.00	$537.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $102.33 / $204.17	Professional		$47.86	$102.33	$204.17
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $61.66 / $95.50	Professional	26	$30.90	$61.66	$95.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $44.67 / $89.13	Professional	TC	$17.78	$44.67	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $154.88 / $537.03	Facility		$16.98	$154.88	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $104.71 / $165.96	Professional		$50.12	$104.71	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $53.70 / $81.28	Professional	26	$29.51	$53.70	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $43.65 / $87.10	Professional	TC	$18.20	$43.65	$87.10
Medcost Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $89.13 / $186.21	Facility		$41.69	$89.13	$186.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $436.52 / $660.69	Facility		$109.65	$436.52	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $79.43 / $144.54	Professional		$45.71	$79.43	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $75.86	Professional	26	$28.18	$44.67	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $34.67 / $69.18	Professional	TC	$18.20	$34.67	$69.18