Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.40 / $480.61 / $891.99	Facility		$96.40	$480.61	$891.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.01 / $28.54 / $40.17	Facility	26	$23.01	$28.54	$40.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.97 / $138.10 / $385.90	Professional		$90.97	$138.10	$385.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.02 / $31.58 / $138.55	Professional	26	$23.02	$31.58	$138.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.88 / $48.24 / $61.85	Professional	52	$42.88	$48.24	$61.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.95 / $83.28 / $155.47	Professional	TC	$67.95	$83.28	$155.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.33 / $105.66 / $172.01	Professional		$79.33	$105.66	$172.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.09 / $29.82 / $44.95	Professional	26	$20.09	$29.82	$44.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $73.18 / $87.08 / $102.45	Professional	TC	$73.18	$87.08	$102.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.30 / $334.17 / $605.87	Facility		$151.30	$334.17	$605.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.29 / $119.60 / $216.58	Professional		$98.29	$119.60	$216.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.11 / $49.50 / $85.11	Professional	26	$25.11	$49.50	$85.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.50 / $73.55 / $143.08	Professional	TC	$52.50	$73.55	$143.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $319.88 / $376.87 / $534.71	Facility		$319.88	$376.87	$534.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.39 / $125.35 / $228.97	Professional		$88.39	$125.35	$228.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $35.22 / $54.92	Professional	26	$25.14	$35.22	$54.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.42 / $95.01 / $178.59	Professional	TC	$59.42	$95.01	$178.59
Medcost Facility/Professional Facility Modifier Low / Median / High Price $95.52 / $131.00 / $259.31	Facility		$95.52	$131.00	$259.31
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $39.36 / $47.00 / $72.53	Facility	26	$39.36	$47.00	$72.53
Medcost Facility/Professional Professional Modifier Low / Median / High Price $402.70 / $402.70 / $402.70	Professional		$402.70	$402.70	$402.70
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $100.32 / $100.32 / $100.32	Professional	26	$100.32	$100.32	$100.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $98.86 / $180.58	Professional		$44.14	$98.86	$180.58
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 $95.60 / $117.10 / $204.18	Professional		$95.60	$117.10	$204.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $29.29 / $51.08	Professional	26	$23.60	$29.29	$51.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.94 / $90.85 / $145.69	Professional	TC	$69.94	$90.85	$145.69