Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.39 / $94.98 / $115.91	Facility		$9.39	$94.98	$115.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.49 / $6.49 / $6.49	Facility	26	$6.49	$6.49	$6.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.39 / $13.31 / $22.21	Professional		$9.39	$13.31	$22.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $8.25 / $12.01	Professional	26	$6.49	$8.25	$12.01
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.36 / $11.36 / $11.36	Professional	50	$11.36	$11.36	$11.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.90 / $3.89 / $6.29	Professional	TC	$2.90	$3.89	$6.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.52 / $14.52 / $14.52	Professional		$14.52	$14.52	$14.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.35 / $53.71 / $87.71	Facility		$26.35	$53.71	$87.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.37 / $14.18 / $23.37	Professional		$10.37	$14.18	$23.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.16 / $11.50 / $17.62	Professional	26	$7.16	$11.50	$17.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2.50 / $3.22 / $4.51	Professional	TC	$2.50	$3.22	$4.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.57 / $86.64 / $128.91	Facility		$16.57	$86.64	$128.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.17 / $15.62 / $25.82	Professional		$11.17	$15.62	$25.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.02 / $18.51	Professional	26	$8.23	$11.02	$18.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.22 / $4.66 / $8.49	Professional	TC	$2.22	$4.66	$8.49
Medcost Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $18.64 / $28.49	Facility		$10.23	$18.64	$28.49
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $13.06 / $16.00 / $21.60	Facility	26	$13.06	$16.00	$21.60
Medcost Facility/Professional Professional Modifier Low / Median / High Price $41.18 / $41.18 / $41.18	Professional		$41.18	$41.18	$41.18
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $28.34 / $28.34 / $28.34	Professional	26	$28.34	$28.34	$28.34
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $61.77 / $61.77 / $61.77	Professional	50	$61.77	$61.77	$61.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.48 / $13.48 / $13.48	Professional		$13.48	$13.48	$13.48
United Facility/Professional Facility Modifier Low / Median / High Price $103.29 / $119.22 / $157.13	Facility		$103.29	$119.22	$157.13
United Facility/Professional Professional Modifier Low / Median / High Price $10.67 / $13.82 / $22.75	Professional		$10.67	$13.82	$22.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.47 / $9.17 / $15.77	Professional	26	$7.47	$9.17	$15.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.97 / $4.15 / $6.79	Professional	TC	$2.97	$4.15	$6.79