Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.77 / $180.20 / $180.20	Facility		$22.77	$180.20	$180.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.07 / $3.07 / $3.07	Facility	26	$3.07	$3.07	$3.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $30.44 / $61.75	Professional		$20.35	$30.44	$61.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.83 / $3.77 / $14.30	Professional	26	$2.83	$3.77	$14.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $7.84 / $10.95 / $11.46	Professional	52	$7.84	$10.95	$11.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.96 / $23.42 / $37.97	Professional	TC	$16.96	$23.42	$37.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $36.61 / $36.61	Professional		$36.61	$36.61	$36.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.09 / $240.99 / $412.24	Facility		$120.09	$240.99	$412.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $24.31 / $64.27	Professional		$20.46	$24.31	$64.27
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $2.77 / $18.00 / $27.58	Professional	26	$2.77	$18.00	$27.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $5.00 / $17.69 / $43.87	Professional	TC	$5.00	$17.69	$43.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.55 / $36.31 / $75.69	Professional		$20.55	$36.31	$75.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.08 / $5.30 / $16.19	Professional	26	$3.08	$5.30	$16.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.47 / $28.21 / $54.44	Professional	TC	$17.47	$28.21	$54.44
Medcost Facility/Professional Facility Modifier Low / Median / High Price $22.77 / $39.29 / $66.20	Facility		$22.77	$39.29	$66.20
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $4.01 / $11.00 / $12.00	Facility	26	$4.01	$11.00	$12.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $80.56 / $80.56 / $80.56	Professional		$80.56	$80.56	$80.56
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $10.97 / $10.97	Professional	26	$10.97	$10.97	$10.97
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $120.83 / $120.83 / $120.83	Professional	50	$120.83	$120.83	$120.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $34.77 / $51.41	Professional		$25.48	$34.77	$51.41
United Facility/Professional Professional Modifier Low / Median / High Price $20.26 / $28.71 / $53.06	Professional		$20.26	$28.71	$53.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.01 / $4.09 / $12.62	Professional	26	$3.01	$4.09	$12.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.21 / $23.18 / $37.29	Professional	TC	$17.21	$23.18	$37.29