Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $199.53 / $416.87	Facility		$37.15	$199.53	$416.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $20.89 / $20.89	Facility	26	$20.89	$20.89	$20.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.85 / $316.23 / $501.19	Facility	TC	$15.85	$316.23	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $66.07 / $125.89	Professional		$33.88	$66.07	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.70 / $77.62	Professional	26	$18.20	$25.70	$77.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $234.42 / $338.84	Professional	50	$77.62	$234.42	$338.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.92 / $30.20 / $100.00	Professional	52	$26.92	$30.20	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $25.70 / $87.10	Professional	TC	$14.13	$25.70	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $46.77	Professional		$30.20	$33.11	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $19.05 / $37.15	Professional	26	$17.78	$19.05	$37.15
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $41.69 / $48.98	Professional	50	$41.69	$41.69	$48.98
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $7.76 / $7.76 / $7.76	Professional	52	$7.76	$7.76	$7.76
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $13.49 / $14.79	Professional	TC	$11.48	$13.49	$14.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $213.80 / $389.05	Facility		$123.03	$213.80	$389.05
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $147.91 / $147.91 / $199.53	Facility	TC	$147.91	$147.91	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $41.69 / $95.50	Professional		$36.31	$41.69	$95.50
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $29.51 / $43.65	Professional	26	$20.42	$29.51	$43.65
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $15.85 / $51.29	Professional	TC	$7.94	$15.85	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $72.44 / $114.82	Professional		$33.88	$72.44	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $42.66	Professional	26	$19.05	$26.92	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $45.71 / $70.79	Professional	TC	$15.85	$45.71	$70.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	26	$40.74	$40.74	$40.74
Medcost Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $70.79 / $131.83	Facility		$38.02	$70.79	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $645.65 / $851.14	Facility		$562.34	$645.65	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $107.15	Professional		$39.81	$60.26	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $23.44 / $36.31	Professional	26	$19.50	$23.44	$36.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $33.88 / $64.57	Professional	TC	$18.20	$33.88	$64.57