Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.01 / $690.71 / $841.62	Facility		$158.01	$690.71	$841.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.51 / $26.33 / $55.75	Facility	26	$23.51	$26.33	$55.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $127.43 / $325.48	Professional		$113.82	$127.43	$325.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $23.93 / $93.20	Professional	26	$18.45	$23.93	$93.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.33 / $106.95 / $167.26	Professional	TC	$97.33	$106.95	$167.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.36 / $127.00 / $165.40	Professional		$101.36	$127.00	$165.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $22.65 / $37.72	Professional	26	$16.84	$22.65	$37.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.70 / $349.38 / $634.77	Facility		$194.70	$349.38	$634.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.14 / $151.50 / $259.41	Professional		$118.14	$151.50	$259.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.07 / $28.35 / $44.69	Professional	26	$21.07	$28.35	$44.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.07 / $121.80 / $210.52	Professional	TC	$97.07	$121.80	$210.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $319.88 / $512.04 / $544.01	Facility		$319.88	$512.04	$544.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.24 / $187.97 / $291.45	Professional		$143.24	$187.97	$291.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.25 / $26.92 / $44.38	Professional	26	$20.25	$26.92	$44.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.26 / $163.72 / $251.28	Professional	TC	$119.26	$163.72	$251.28
Medcost Facility/Professional Facility Modifier Low / Median / High Price $119.85 / $183.31 / $286.13	Facility		$119.85	$183.31	$286.13
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $20.82 / $35.00 / $52.74	Facility	26	$20.82	$35.00	$52.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $464.53 / $464.53 / $464.53	Professional		$464.53	$464.53	$464.53
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $696.79 / $696.79 / $696.79	Professional	50	$696.79	$696.79	$696.79
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $380.25 / $380.25 / $380.25	Professional	TC	$380.25	$380.25	$380.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $120.74 / $186.97	Professional		$44.14	$120.74	$186.97
United Facility/Professional Professional Modifier Low / Median / High Price $133.69 / $179.59 / $294.32	Professional		$133.69	$179.59	$294.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.92 / $24.35 / $40.64	Professional	26	$18.92	$24.35	$40.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.90 / $156.30 / $265.70	Professional	TC	$108.90	$156.30	$265.70