Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $512.86 / $954.99	Facility		$85.11	$512.86	$954.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $35.48 / $48.98	Facility	26	$27.54	$35.48	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $407.38	Professional		$56.23	$104.71	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $56.23 / $144.54	Professional	26	$28.18	$56.23	$144.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $158.49 / $707.95	Professional	50	$47.86	$158.49	$707.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $52.48 / $120.23	Professional	TC	$41.69	$52.48	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $147.91	Professional		$63.10	$77.62	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.90 / $54.95	Professional	26	$24.55	$30.90	$54.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $117.49 / $229.09	Professional	50	$114.82	$117.49	$229.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $45.71 / $53.70	Professional	TC	$39.81	$45.71	$53.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $218.78 / $380.19	Facility		$117.49	$218.78	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $117.49	Professional		$75.86	$85.11	$117.49
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $48.98 / $75.86	Professional	26	$31.62	$48.98	$75.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $47.86 / $67.61	Professional	TC	$20.42	$47.86	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $257.04 / $446.68	Facility		$51.29	$257.04	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $165.96	Professional		$77.62	$109.65	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $43.65 / $67.61	Professional	26	$30.90	$43.65	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $64.57 / $102.33	Professional	TC	$48.98	$64.57	$102.33
Medcost Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $100.00 / $199.53	Facility		$70.79	$100.00	$199.53
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 $81.28 / $363.08 / $562.34	Facility		$81.28	$363.08	$562.34
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $158.49	Professional		$70.79	$89.13	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $35.48 / $63.10	Professional	26	$28.18	$35.48	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $54.95 / $95.50	Professional	TC	$43.65	$54.95	$95.50