Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $460.47 / $1,173.06 / $2,517.12	Facility		$460.47	$1,173.06	$2,517.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.81 / $70.83 / $166.26	Facility	26	$70.81	$70.83	$166.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.86 / $280.75 / $1,343.00	Professional		$183.86	$280.75	$1,343.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.64 / $77.94 / $350.51	Professional	26	$63.64	$77.94	$350.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.85 / $175.12 / $323.18	Professional	TC	$124.85	$175.12	$323.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.54 / $188.63 / $307.07	Professional		$141.54	$188.63	$307.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.41 / $97.37 / $113.92	Professional	26	$68.41	$97.37	$113.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $111.83 / $156.56 / $156.56	Professional	TC	$111.83	$156.56	$156.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $591.04 / $1,343.85 / $2,349.67	Facility		$591.04	$1,343.85	$2,349.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.47 / $319.95 / $589.11	Professional		$175.47	$319.95	$589.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.64 / $90.30 / $152.97	Professional	26	$63.64	$90.30	$152.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $111.83 / $215.00 / $378.03	Professional	TC	$111.83	$215.00	$378.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $483.72 / $483.72 / $483.72	Facility		$483.72	$483.72	$483.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.03 / $298.66 / $458.88	Professional		$216.03	$298.66	$458.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.48 / $93.52 / $163.37	Professional	26	$71.48	$93.52	$163.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.90 / $205.95 / $293.80	Professional	TC	$139.90	$205.95	$293.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $197.36 / $288.88 / $464.77	Facility		$197.36	$288.88	$464.77
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $83.39 / $186.89	Facility	26	$79.43	$83.39	$186.89
Medcost Facility/Professional Professional Modifier Low / Median / High Price $712.04 / $712.04 / $712.04	Professional		$712.04	$712.04	$712.04
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $459.45 / $459.45 / $459.45	Professional	TC	$459.45	$459.45	$459.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $135.55 / $228.84	Professional		$64.59	$135.55	$228.84
United Facility/Professional Professional Modifier Low / Median / High Price $184.00 / $256.83 / $424.18	Professional		$184.00	$256.83	$424.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.72 / $83.34 / $130.66	Professional	26	$61.72	$83.34	$130.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.69 / $177.39 / $282.33	Professional	TC	$118.69	$177.39	$282.33