Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.40 / $342.43 / $438.91	Facility		$106.40	$342.43	$438.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.57 / $25.57 / $25.57	Facility	26	$25.57	$25.57	$25.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.71 / $81.06 / $119.65	Professional		$39.71	$81.06	$119.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.57 / $45.34 / $185.65	Professional	26	$25.57	$45.34	$185.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.51 / $134.63 / $134.63	Professional	50	$94.51	$134.63	$134.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.14 / $31.38 / $45.95	Professional	TC	$14.14	$31.38	$45.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.78 / $42.78 / $50.33	Professional	26	$42.78	$42.78	$50.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.55 / $351.01 / $576.36	Facility		$181.55	$351.01	$576.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.75 / $114.00 / $215.00	Professional		$43.75	$114.00	$215.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.12 / $64.00 / $107.80	Professional	26	$28.12	$64.00	$107.80
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.62 / $50.00 / $133.72	Professional	TC	$15.62	$50.00	$133.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.56 / $331.26 / $534.71	Facility		$110.56	$331.26	$534.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.38 / $99.70 / $152.85	Professional		$54.38	$99.70	$152.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $53.64 / $77.31	Professional	26	$32.78	$53.64	$77.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.08 / $42.77 / $78.86	Professional	TC	$21.08	$42.77	$78.86
Medcost Facility/Professional Facility Modifier Low / Median / High Price $44.33 / $119.13 / $193.00	Facility		$44.33	$119.13	$193.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $54.67 / $60.00 / $92.10	Facility	26	$54.67	$60.00	$92.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $171.49 / $171.49 / $171.49	Professional		$171.49	$171.49	$171.49
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $110.18 / $110.18 / $110.18	Professional	26	$110.18	$110.18	$110.18
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $257.23 / $257.23 / $257.23	Professional	50	$257.23	$257.23	$257.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $51.99 / $90.40	Professional		$29.53	$51.99	$90.40
United Facility/Professional Facility Modifier Low / Median / High Price $108.97 / $108.97 / $123.98	Facility		$108.97	$108.97	$123.98
United Facility/Professional Professional Modifier Low / Median / High Price $46.78 / $79.88 / $146.04	Professional		$46.78	$79.88	$146.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $44.09 / $78.09	Professional	26	$28.91	$44.09	$78.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $32.76 / $66.88	Professional	TC	$19.48	$32.76	$66.88