Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $104.71 / $323.59	Facility		$100.00	$104.71	$323.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $60.26	Facility	26	$57.54	$57.54	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $87.10 / $398.11	Professional		$44.67	$87.10	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $46.77 / $91.20	Professional	26	$33.88	$46.77	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $165.96	Professional	TC	$25.70	$37.15	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $30.20 / $31.62	Professional		$21.38	$30.20	$31.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $407.38 / $660.69	Facility		$186.21	$407.38	$660.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $74.13 / $173.78	Professional		$44.67	$74.13	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $239.88 / $331.13	Professional		$107.15	$239.88	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $144.54	Professional	26	$61.66	$95.50	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $144.54 / $204.17	Professional	TC	$43.65	$144.54	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $125.89 / $354.81	Facility		$64.57	$125.89	$354.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $229.09 / $331.13	Professional		$72.44	$229.09	$331.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $89.13 / $131.83	Professional	26	$42.66	$89.13	$131.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $138.04 / $204.17	Professional	TC	$30.90	$138.04	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $1,096.48 / $1,412.54	Facility		$229.09	$1,096.48	$1,412.54
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $251.19 / $380.19	Professional		$83.18	$251.19	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $95.50 / $141.25	Professional	26	$46.77	$95.50	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $154.88 / $245.47	Professional	TC	$35.48	$154.88	$245.47