Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.80 / $688.50 / $1,095.67	Facility		$257.80	$688.50	$1,095.67
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $22.70 / $34.90	Facility	26	$22.69	$22.70	$34.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $105.77 / $383.35	Professional		$75.17	$105.77	$383.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $26.47 / $110.23	Professional	26	$22.70	$26.47	$110.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.89 / $72.23 / $207.56	Professional	TC	$49.89	$72.23	$207.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.76 / $109.76 / $182.76	Professional		$109.76	$109.76	$182.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.62 / $27.24 / $39.20	Professional	26	$26.62	$27.24	$39.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $689.52 / $689.52 / $689.52	Facility		$689.52	$689.52	$689.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $108.26 / $160.00	Professional		$95.00	$108.26	$160.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.76 / $72.00 / $126.60	Professional	26	$24.76	$72.00	$126.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $48.09 / $86.90	Professional	TC	$23.00	$48.09	$86.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.75 / $173.75 / $290.41	Facility		$173.75	$173.75	$290.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.84 / $117.84 / $278.04	Professional		$70.84	$117.84	$278.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $36.36 / $66.48	Professional	26	$24.28	$36.36	$66.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.04 / $80.73 / $208.12	Professional	TC	$43.04	$80.73	$208.12
Medcost Facility/Professional Facility Modifier Low / Median / High Price $80.92 / $114.46 / $225.62	Facility		$80.92	$114.46	$225.62
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $35.90 / $41.28 / $61.79	Facility	26	$35.90	$41.28	$61.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.51 / $121.67 / $200.14	Professional		$48.51	$121.67	$200.14
United Facility/Professional Professional Modifier Low / Median / High Price $72.37 / $111.09 / $210.02	Professional		$72.37	$111.09	$210.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.65 / $31.38 / $55.01	Professional	26	$24.65	$31.38	$55.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.03 / $75.34 / $153.24	Professional	TC	$53.03	$75.34	$153.24