Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $154.88 / $363.08	Facility		$33.11	$154.88	$363.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $12.02 / $15.14	Facility	26	$10.72	$12.02	$15.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $33.88 / $309.03	Facility	TC	$22.91	$33.88	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $32.36 / $112.20	Professional		$20.89	$32.36	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.33 / $36.31	Professional	26	$6.03	$9.33	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $19.95 / $67.61	Professional	TC	$14.13	$19.95	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $20.89	Professional		$18.20	$18.20	$20.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $19.95	Professional	TC	$19.95	$19.95	$19.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $512.86 / $851.14	Facility		$204.17	$512.86	$851.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $19.05 / $35.48	Professional		$6.03	$19.05	$35.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $18.20 / $18.20	Facility		$18.20	$18.20	$18.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $34.67 / $48.98	Professional		$23.44	$34.67	$48.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.22 / $17.38	Professional	26	$7.41	$11.22	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $22.39 / $32.36	Professional	TC	$16.22	$22.39	$32.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $32.36 / $33.11	Professional		$14.79	$32.36	$33.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $38.02 / $61.66	Facility		$26.30	$38.02	$61.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $42.66 / $67.61	Professional		$25.12	$42.66	$67.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.30 / $17.38	Professional	26	$7.59	$12.30	$17.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $23.99 / $31.62	Professional	TC	$17.38	$23.99	$31.62
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $457.09 / $457.09	Facility		$204.17	$457.09	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $28.84 / $56.23	Professional		$25.70	$28.84	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.12 / $17.38	Professional	26	$8.32	$9.12	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $19.95 / $38.90	Professional	TC	$16.98	$19.95	$38.90