Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.03 / $87.07 / $243.00	Professional		$64.03	$87.07	$243.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $61.62 / $339.16	Professional	26	$27.06	$61.62	$339.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.27 / $57.67 / $145.25	Professional	TC	$35.27	$57.67	$145.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $55.79 / $101.43	Professional		$50.72	$55.79	$101.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.88 / $34.15 / $36.54	Professional	26	$15.88	$34.15	$36.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.84 / $34.84 / $34.84	Professional	TC	$34.84	$34.84	$34.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $74.55 / $122.41	Professional		$71.00	$74.55	$122.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.77 / $48.00 / $56.11	Professional	26	$31.77	$48.00	$56.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $24.15 / $70.02	Professional	TC	$23.00	$24.15	$70.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.42 / $43.42 / $43.42	Facility		$43.42	$43.42	$43.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.51 / $17.51 / $17.51	Facility	26	$17.51	$17.51	$17.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.92 / $25.92 / $25.92	Facility	TC	$25.92	$25.92	$25.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $50.66 / $123.97	Professional		$42.30	$50.66	$123.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.91 / $22.42 / $112.00	Professional	26	$17.91	$22.42	$112.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.52 / $30.50 / $74.06	Professional	TC	$19.52	$30.50	$74.06
Medcost Facility/Professional Facility Modifier Low / Median / High Price $73.14 / $105.00 / $147.04	Facility		$73.14	$105.00	$147.04
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $55.00 / $66.00 / $115.00	Facility	26	$55.00	$66.00	$115.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $73.65 / $77.20 / $97.43	Facility	TC	$73.65	$77.20	$97.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.28 / $85.68 / $154.20	Professional		$45.28	$85.68	$154.20
United Facility/Professional Professional Modifier Low / Median / High Price $54.56 / $70.53 / $163.31	Professional		$54.56	$70.53	$163.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.54 / $25.07 / $78.84	Professional	26	$20.54	$25.07	$78.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.77 / $49.26 / $103.97	Professional	TC	$30.77	$49.26	$103.97