Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.46 / $822.15 / $1,171.72	Facility		$240.46	$822.15	$1,171.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.54 / $38.54 / $55.28	Facility	26	$38.54	$38.54	$55.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $200.61 / $220.59 / $740.61	Facility	TC	$200.61	$220.59	$740.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $239.17 / $499.66	Professional		$189.31	$239.17	$499.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $38.54 / $95.58	Professional	26	$26.96	$38.54	$95.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.93 / $200.61 / $345.46	Professional	TC	$159.93	$200.61	$345.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.24 / $226.86 / $377.74	Professional		$174.24	$226.86	$377.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $37.14 / $61.84	Professional	26	$27.64	$37.14	$61.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $146.22 / $146.22 / $176.48	Professional	TC	$146.22	$146.22	$176.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.50 / $563.79 / $964.56	Facility		$288.50	$563.79	$964.56
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $208.26 / $277.68 / $1,412.26	Facility	TC	$208.26	$277.68	$1,412.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.03 / $250.38 / $376.28	Professional		$211.03	$250.38	$376.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $54.00 / $77.34	Professional	26	$34.54	$54.00	$77.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $160.00 / $187.23 / $290.25	Professional	TC	$160.00	$187.23	$290.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $712.96 / $957.99 / $1,215.45	Facility		$712.96	$957.99	$1,215.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.88 / $309.52 / $483.35	Professional		$232.88	$309.52	$483.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.58 / $41.41 / $72.78	Professional	26	$30.58	$41.41	$72.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $207.50 / $274.30 / $420.54	Professional	TC	$207.50	$274.30	$420.54
Medcost Facility/Professional Facility Modifier Low / Median / High Price $188.24 / $289.39 / $511.54	Facility		$188.24	$289.39	$511.54
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $35.34 / $51.00 / $82.46	Facility	26	$35.34	$51.00	$82.46
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $154.44 / $230.19 / $429.79	Facility	TC	$154.44	$230.19	$429.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $867.34 / $867.34 / $867.34	Professional		$867.34	$867.34	$867.34
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $138.74 / $138.74 / $138.74	Professional	26	$138.74	$138.74	$138.74
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $1,301.01 / $1,301.01 / $1,301.01	Professional	50	$1,301.01	$1,301.01	$1,301.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $221.49 / $347.31	Professional		$44.14	$221.49	$347.31
United Facility/Professional Professional Modifier Low / Median / High Price $225.12 / $290.73 / $467.00	Professional		$225.12	$290.73	$467.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.88 / $39.34 / $71.66	Professional	26	$27.88	$39.34	$71.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.27 / $251.50 / $423.91	Professional	TC	$190.27	$251.50	$423.91