Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.78 / $488.75 / $586.50	Facility		$47.78	$488.75	$586.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	26	$31.05	$31.05	$31.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.35 / $80.09 / $232.90	Professional		$44.35	$80.09	$232.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.10 / $34.75 / $75.92	Professional	26	$28.10	$34.75	$75.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $209.18 / $219.30 / $474.30	Professional	50	$209.18	$219.30	$474.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.89 / $24.08 / $39.68	Professional	52	$23.89	$24.08	$39.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.73 / $34.54 / $79.62	Professional	TC	$16.73	$34.54	$79.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $60.34 / $60.34	Professional		$60.34	$60.34	$60.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $103.20 / $216.24 / $384.48	Facility		$103.20	$216.24	$384.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.10 / $58.94 / $106.63	Professional		$43.10	$58.94	$106.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.00 / $27.77 / $38.88	Professional	26	$18.00	$27.77	$38.88
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.33 / $37.00 / $67.45	Professional	TC	$15.33	$37.00	$67.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.15 / $85.42 / $117.34	Professional		$56.15	$85.42	$117.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.08 / $35.35 / $57.49	Professional	26	$26.08	$35.35	$57.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.12 / $46.31 / $71.83	Professional	TC	$22.12	$46.31	$71.83
Medcost Facility/Professional Facility Modifier Low / Median / High Price $50.36 / $85.00 / $140.13	Facility		$50.36	$85.00	$140.13
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $29.00 / $31.00 / $61.91	Facility	26	$29.00	$31.00	$61.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $177.23 / $177.23 / $177.23	Professional		$177.23	$177.23	$177.23
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $108.82 / $108.82 / $108.82	Professional	26	$108.82	$108.82	$108.82
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $265.83 / $265.83 / $265.83	Professional	50	$265.83	$265.83	$265.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $52.12 / $91.58	Professional		$29.53	$52.12	$91.58
United Facility/Professional Professional Modifier Low / Median / High Price $53.99 / $73.05 / $107.61	Professional		$53.99	$73.05	$107.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.67 / $31.76 / $50.98	Professional	26	$24.67	$31.76	$50.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.67 / $40.33 / $65.55	Professional	TC	$22.67	$40.33	$65.55