Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.76 / $198.05 / $4,869.64	Facility		$94.76	$198.05	$4,869.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.69 / $21.69 / $21.69	Facility	26	$21.69	$21.69	$21.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.07 / $362.60 / $498.47	Facility	TC	$16.07	$362.60	$498.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.08 / $69.48 / $117.34	Professional		$36.08	$69.48	$117.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.32 / $22.01 / $80.75	Professional	26	$19.32	$22.01	$80.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.74 / $234.74 / $281.35	Professional	50	$234.74	$234.74	$281.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.97 / $18.89 / $23.73	Professional	52	$17.97	$18.89	$23.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.38 / $30.45 / $74.20	Professional	TC	$15.38	$30.45	$74.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.20 / $31.37 / $46.97	Professional		$31.20	$31.37	$46.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.77 / $22.00 / $22.00	Professional	26	$17.77	$22.00	$22.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.09 / $239.61 / $412.24	Facility		$120.09	$239.61	$412.24
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $136.94 / $182.58 / $182.58	Facility	TC	$136.94	$182.58	$182.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $43.62 / $91.89	Professional		$33.54	$43.62	$91.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.11 / $33.00 / $44.51	Professional	26	$19.11	$33.00	$44.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.00 / $14.44 / $44.63	Professional	TC	$8.00	$14.44	$44.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.64 / $71.30 / $126.91	Professional		$38.64	$71.30	$126.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.49 / $28.47 / $43.30	Professional	26	$20.49	$28.47	$43.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $46.56 / $84.53	Professional	TC	$17.91	$46.56	$84.53
Medcost Facility/Professional Facility Modifier Low / Median / High Price $38.03 / $75.95 / $123.69	Facility		$38.03	$75.95	$123.69
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $23.00 / $25.00 / $54.62	Facility	26	$23.00	$25.00	$54.62
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $18.04 / $56.33 / $94.63	Facility	TC	$18.04	$56.33	$94.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $132.22 / $132.22 / $132.22	Professional		$132.22	$132.22	$132.22
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $198.33 / $198.33 / $198.33	Professional	50	$198.33	$198.33	$198.33
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $56.60 / $56.60 / $56.60	Professional	TC	$56.60	$56.60	$56.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $35.14 / $51.41	Professional		$25.48	$35.14	$51.41
United Facility/Professional Professional Modifier Low / Median / High Price $42.71 / $59.72 / $105.82	Professional		$42.71	$59.72	$105.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $24.59 / $36.29	Professional	26	$20.30	$24.59	$36.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.40 / $30.46 / $61.40	Professional	TC	$21.40	$30.46	$61.40