Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.82 / $592.13 / $817.28	Facility		$97.82	$592.13	$817.28
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.91 / $29.64 / $41.72	Facility	26	$23.91	$29.64	$41.72
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.41 / $378.04 / $759.44	Facility	TC	$48.41	$378.04	$759.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $107.68 / $364.65	Professional		$72.31	$107.68	$364.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.91 / $40.43 / $154.38	Professional	26	$23.91	$40.43	$154.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.41 / $71.45 / $117.26	Professional	TC	$48.41	$71.45	$117.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $84.19 / $137.06	Professional		$65.00	$84.19	$137.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.86 / $30.98 / $46.68	Professional	26	$20.86	$30.98	$46.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $52.24 / $62.17 / $73.14	Professional	TC	$52.24	$62.17	$73.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $185.68 / $342.24 / $610.37	Facility		$185.68	$342.24	$610.37
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $121.18 / $161.57 / $886.09	Facility	TC	$121.18	$161.57	$886.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.31 / $107.16 / $182.48	Professional		$78.31	$107.16	$182.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.08 / $53.00 / $93.19	Professional	26	$26.08	$53.00	$93.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.00 / $58.74 / $99.24	Professional	TC	$50.00	$58.74	$99.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.04 / $365.13 / $534.71	Facility		$269.04	$365.13	$534.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.56 / $110.62 / $192.82	Professional		$84.56	$110.62	$192.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.13 / $36.86 / $58.37	Professional	26	$27.13	$36.86	$58.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.64 / $74.38 / $134.52	Professional	TC	$56.64	$74.38	$134.52
Medcost Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $134.00 / $208.63	Facility		$78.00	$134.00	$208.63
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $41.91 / $50.00 / $77.01	Facility	26	$41.91	$50.00	$77.01
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $75.75 / $103.49 / $185.02	Facility	TC	$75.75	$103.49	$185.02
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $88.83 / $316.70	Professional		$88.83	$88.83	$316.70
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $104.14 / $104.14 / $104.14	Professional	26	$104.14	$104.14	$104.14
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 $108.97 / $108.97 / $123.98	Facility		$108.97	$108.97	$123.98
United Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $101.95 / $176.23	Professional		$76.06	$101.95	$176.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.53 / $32.35 / $57.90	Professional	26	$24.53	$32.35	$57.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.38 / $69.08 / $116.42	Professional	TC	$53.38	$69.08	$116.42