Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.00 / $607.38 / $1,025.33	Facility		$74.00	$607.38	$1,025.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.88 / $14.73 / $21.08	Facility	26	$11.88	$14.73	$21.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.61 / $34.42 / $75.08	Professional		$28.61	$34.42	$75.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $15.24 / $82.00	Professional	26	$11.88	$15.24	$82.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.25 / $43.20	Professional	TC	$17.89	$21.25	$43.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $27.77 / $34.71	Professional		$27.77	$27.77	$34.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.51 / $13.55 / $22.55	Professional	26	$11.51	$13.55	$22.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.06 / $75.06 / $233.58	Facility		$75.06	$75.06	$233.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $37.79 / $60.08	Professional		$34.71	$37.79	$60.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $19.00 / $31.71	Professional	26	$12.60	$19.00	$31.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $22.12 / $30.25	Professional	TC	$17.00	$22.12	$30.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.59 / $73.59 / $125.31	Facility		$73.59	$73.59	$125.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.80 / $40.14 / $70.20	Professional		$30.80	$40.14	$70.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $18.39 / $30.44	Professional	26	$13.80	$18.39	$30.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $22.55 / $44.10	Professional	TC	$17.00	$22.55	$44.10
Medcost Facility/Professional Facility Modifier Low / Median / High Price $32.22 / $50.00 / $77.50	Facility		$32.22	$50.00	$77.50
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $21.71 / $26.00 / $37.97	Facility	26	$21.71	$26.00	$37.97
Medcost Facility/Professional Professional Modifier Low / Median / High Price $140.76 / $140.76 / $140.76	Professional		$140.76	$140.76	$140.76
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $91.01 / $91.01 / $91.01	Professional	TC	$91.01	$91.01	$91.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $36.41 / $55.69	Professional		$26.31	$36.41	$55.69
United Facility/Professional Professional Modifier Low / Median / High Price $28.62 / $37.17 / $66.91	Professional		$28.62	$37.17	$66.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.79 / $16.38 / $29.80	Professional	26	$12.79	$16.38	$29.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.28 / $22.37 / $42.75	Professional	TC	$16.28	$22.37	$42.75