Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.98 / $736.25 / $1,127.95	Facility		$213.98	$736.25	$1,127.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.99 / $38.99 / $91.54	Facility	26	$38.99	$38.99	$91.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.58 / $204.21 / $399.78	Professional		$168.58	$204.21	$399.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.83 / $38.99 / $80.37	Professional	26	$30.83	$38.99	$80.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.35 / $162.49 / $265.99	Professional	TC	$136.35	$162.49	$265.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.54 / $172.72 / $224.94	Professional		$128.54	$172.72	$224.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.98 / $50.84 / $63.63	Professional	26	$28.98	$50.84	$63.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $175.17 / $175.17 / $175.17	Professional	TC	$175.17	$175.17	$175.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $305.67 / $557.20 / $948.80	Facility		$305.67	$557.20	$948.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.66 / $223.00 / $392.10	Professional		$160.66	$223.00	$392.10
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.54 / $61.00 / $82.28	Professional	26	$35.54	$61.00	$82.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.12 / $170.10 / $265.27	Professional	TC	$125.12	$170.10	$265.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.39 / $879.41 / $1,215.45	Facility		$644.39	$879.41	$1,215.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.46 / $239.23 / $365.90	Professional		$185.46	$239.23	$365.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.46 / $42.87 / $73.61	Professional	26	$33.46	$42.87	$73.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.36 / $194.09 / $298.31	Professional	TC	$145.36	$194.09	$298.31
Medcost Facility/Professional Facility Modifier Low / Median / High Price $180.01 / $263.00 / $383.80	Facility		$180.01	$263.00	$383.80
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $34.42 / $57.00 / $81.56	Facility	26	$34.42	$57.00	$81.56
Medcost Facility/Professional Professional Modifier Low / Median / High Price $649.48 / $649.48 / $649.48	Professional		$649.48	$649.48	$649.48
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $139.51 / $139.51 / $139.51	Professional	26	$139.51	$139.51	$139.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $152.92 / $238.04	Professional		$44.14	$152.92	$238.04
United Facility/Professional Professional Modifier Low / Median / High Price $167.80 / $220.80 / $358.13	Professional		$167.80	$220.80	$358.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $39.20 / $69.14	Professional	26	$31.12	$39.20	$69.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.87 / $179.68 / $309.08	Professional	TC	$131.87	$179.68	$309.08