Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $707.95 / $1,096.48	Facility		$75.86	$707.95	$1,096.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $33.11 / $64.57	Facility	26	$25.70	$33.11	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $97.72 / $537.03	Professional		$48.98	$97.72	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $42.66 / $177.83	Professional	26	$25.70	$42.66	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.90 / $169.82	Professional	TC	$20.89	$30.90	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $109.65	Professional		$41.69	$52.48	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.84 / $51.29	Professional	26	$22.91	$28.84	$51.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.18 / $33.11	Professional	TC	$28.18	$28.18	$33.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $257.04 / $741.31	Facility		$67.61	$257.04	$741.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $114.82 / $213.80	Professional		$63.10	$114.82	$213.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $50.12 / $77.62	Professional	26	$31.62	$50.12	$77.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $57.54 / $95.50	Professional	TC	$31.62	$57.54	$95.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $602.56 / $741.31	Facility		$446.68	$602.56	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $123.03 / $251.19	Professional		$57.54	$123.03	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.66 / $64.57	Professional	26	$29.51	$42.66	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $56.23 / $199.53	Professional	TC	$25.12	$56.23	$199.53
Medcost Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $102.33 / $269.15	Facility		$51.29	$102.33	$269.15
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 Professional Modifier Low / Median / High Price $51.29 / $112.20 / $234.42	Professional		$51.29	$112.20	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $33.88 / $60.26	Professional	26	$27.54	$33.88	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $48.98 / $186.21	Professional	TC	$22.39	$48.98	$186.21