Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.28 / $895.49 / $1,806.90	Facility		$213.28	$895.49	$1,806.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.27 / $37.71 / $48.27	Facility	26	$34.27	$37.71	$48.27
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $153.53 / $808.85 / $1,320.00	Facility	TC	$153.53	$808.85	$1,320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.24 / $220.94 / $1,037.00	Professional		$172.24	$220.94	$1,037.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.63 / $42.33 / $176.80	Professional	26	$30.63	$42.33	$176.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $149.90 / $168.58 / $286.79	Professional	TC	$149.90	$168.58	$286.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.04 / $177.42 / $295.42	Professional		$165.04	$177.42	$295.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.13 / $42.24 / $54.00	Professional	26	$24.13	$42.24	$54.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $134.87 / $188.82 / $188.82	Professional	TC	$134.87	$188.82	$188.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $211.92 / $495.91 / $964.56	Facility		$211.92	$495.91	$964.56
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $188.96 / $251.95 / $1,412.26	Facility	TC	$188.96	$251.95	$1,412.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.04 / $246.48 / $350.70	Professional		$165.04	$246.48	$350.70
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.17 / $63.00 / $87.49	Professional	26	$30.17	$63.00	$87.49
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.87 / $182.28 / $286.93	Professional	TC	$134.87	$182.28	$286.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $694.58 / $951.21 / $1,215.45	Facility		$694.58	$951.21	$1,215.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.71 / $250.00 / $378.92	Professional		$190.71	$250.00	$378.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.94 / $41.21 / $65.20	Professional	26	$31.94	$41.21	$65.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.24 / $210.07 / $315.86	Professional	TC	$156.24	$210.07	$315.86
Medcost Facility/Professional Facility Modifier Low / Median / High Price $187.80 / $269.00 / $420.95	Facility		$187.80	$269.00	$420.95
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $35.94 / $60.00 / $101.00	Facility	26	$35.94	$60.00	$101.00
Medcost Facility/Professional Facility Modifier TC Low / Median / High Price $154.44 / $197.50 / $327.91	Facility	TC	$154.44	$197.50	$327.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $674.07 / $674.07 / $674.07	Professional		$674.07	$674.07	$674.07
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $551.63 / $551.63 / $551.63	Professional	TC	$551.63	$551.63	$551.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $186.10 / $292.35	Professional		$44.14	$186.10	$292.35
United Facility/Professional Professional Modifier Low / Median / High Price $173.00 / $228.68 / $380.77	Professional		$173.00	$228.68	$380.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $37.14 / $61.92	Professional	26	$30.06	$37.14	$61.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.22 / $190.69 / $325.89	Professional	TC	$142.22	$190.69	$325.89