Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $114.82 / $676.08	Facility		$45.71	$114.82	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $11.75 / $15.14	Facility	26	$10.72	$11.75	$15.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $42.66 / $239.88	Facility	TC	$28.18	$42.66	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $34.67 / $134.90	Professional		$10.96	$34.67	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.96 / $36.31	Professional	26	$6.03	$10.96	$36.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $158.49 / $309.03	Professional	50	$42.66	$158.49	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.92 / $85.11	Professional	TC	$16.98	$26.92	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $21.38 / $25.70	Professional		$18.20	$21.38	$25.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.18 / $28.18	Professional	TC	$28.18	$28.18	$28.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $316.23 / $537.03	Facility		$128.82	$316.23	$537.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $22.39 / $54.95	Professional		$6.03	$22.39	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Facility		$22.39	$22.39	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $40.74 / $61.66	Professional		$27.54	$40.74	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.72 / $15.85	Professional	26	$7.08	$10.72	$15.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.20 / $45.71	Professional	TC	$19.50	$30.20	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $32.36 / $37.15	Professional		$14.79	$32.36	$37.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $43.65 / $69.18	Facility		$31.62	$43.65	$69.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $51.29 / $77.62	Professional		$28.84	$51.29	$77.62
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.96 / $15.85	Professional	26	$7.41	$10.96	$15.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $31.62 / $45.71	Professional	TC	$21.38	$31.62	$45.71
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $380.19 / $380.19	Facility		$169.82	$380.19	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $34.67 / $61.66	Professional		$31.62	$34.67	$61.66
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 $22.39 / $25.70 / $43.65	Professional	TC	$22.39	$25.70	$43.65