Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.30 / $831.00 / $1,446.90	Facility		$142.30	$831.00	$1,446.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.73 / $31.90 / $73.38	Facility	26	$25.73	$31.90	$73.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.17 / $116.28 / $811.35	Professional		$48.17	$116.28	$811.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.73 / $30.80 / $182.52	Professional	26	$25.73	$30.80	$182.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.44 / $37.54 / $170.39	Professional	TC	$22.44	$37.54	$170.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.93 / $75.64 / $96.71	Professional		$45.93	$75.64	$96.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.11 / $31.21 / $50.78	Professional	26	$24.11	$31.21	$50.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.23 / $28.23 / $28.23	Professional	TC	$28.23	$28.23	$28.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.18 / $254.93 / $744.54	Facility		$77.18	$254.93	$744.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.03 / $114.00 / $217.08	Professional		$54.03	$114.00	$217.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $50.00 / $92.51	Professional	26	$28.37	$50.00	$92.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.66 / $64.00 / $112.53	Professional	TC	$25.66	$64.00	$112.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $429.21 / $602.17 / $744.54	Facility		$429.21	$602.17	$744.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.61 / $120.61 / $229.19	Professional		$58.61	$120.61	$229.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $41.52 / $66.37	Professional	26	$30.82	$41.52	$66.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.31 / $56.72 / $172.03	Professional	TC	$25.31	$56.72	$172.03
Medcost Facility/Professional Facility Modifier Low / Median / High Price $52.99 / $152.16 / $248.67	Facility		$52.99	$152.16	$248.67
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $47.85 / $57.00 / $84.64	Facility	26	$47.85	$57.00	$84.64
Medcost Facility/Professional Professional Modifier Low / Median / High Price $208.73 / $208.73 / $208.73	Professional		$208.73	$208.73	$208.73
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $96.78 / $96.78 / $96.78	Professional	TC	$96.78	$96.78	$96.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $51.99 / $90.40	Professional		$29.53	$51.99	$90.40
United Facility/Professional Professional Modifier Low / Median / High Price $52.62 / $95.61 / $246.48	Professional		$52.62	$95.61	$246.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $35.56 / $61.71	Professional	26	$27.61	$35.56	$61.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.61 / $40.15 / $200.57	Professional	TC	$22.61	$40.15	$200.57