Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.82 / $536.00 / $935.30	Facility		$141.82	$536.00	$935.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.62 / $38.04 / $48.70	Facility	26	$27.62	$38.04	$48.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $96.09 / $405.00	Professional		$68.56	$96.09	$405.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.63 / $35.90 / $119.00	Professional	26	$27.63	$35.90	$119.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.66 / $276.00 / $700.05	Professional	50	$45.66	$276.00	$700.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.52 / $50.56 / $106.55	Professional	TC	$42.52	$50.56	$106.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.07 / $76.77 / $152.59	Professional		$63.07	$76.77	$152.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.35 / $36.71 / $54.49	Professional	26	$24.35	$36.71	$54.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $94.60 / $123.79 / $123.79	Professional	50	$94.60	$123.79	$123.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.72 / $243.20 / $377.66	Facility		$124.72	$243.20	$377.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.75 / $83.41 / $147.50	Professional		$73.75	$83.41	$147.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $55.00 / $79.86	Professional	26	$30.44	$55.00	$79.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $42.86 / $63.36	Professional	TC	$20.50	$42.86	$63.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $238.62 / $274.29 / $442.75	Facility		$238.62	$274.29	$442.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.88 / $104.69 / $174.83	Professional		$85.88	$104.69	$174.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $42.88 / $67.93	Professional	26	$34.61	$42.88	$67.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.63 / $63.84 / $105.11	Professional	TC	$51.63	$63.84	$105.11
Medcost Facility/Professional Facility Modifier Low / Median / High Price $70.15 / $125.84 / $199.40	Facility		$70.15	$125.84	$199.40
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $50.61 / $51.00 / $87.02	Facility	26	$50.61	$51.00	$87.02
Medcost Facility/Professional Professional Modifier Low / Median / High Price $305.73 / $305.73 / $305.73	Professional		$305.73	$305.73	$305.73
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $119.12 / $119.12 / $119.12	Professional	26	$119.12	$119.12	$119.12
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $458.60 / $458.60 / $458.60	Professional	50	$458.60	$458.60	$458.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $83.61 / $137.35	Professional		$44.14	$83.61	$137.35
United Facility/Professional Facility Modifier Low / Median / High Price $80.90 / $80.90 / $100.78	Facility		$80.90	$80.90	$100.78
United Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $96.96 / $160.44	Professional		$73.48	$96.96	$160.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $37.88 / $63.65	Professional	26	$28.41	$37.88	$63.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.68 / $55.10 / $95.29	Professional	TC	$44.68	$55.10	$95.29