Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.31 / $228.76 / $1,203.20	Facility		$81.31	$228.76	$1,203.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.30 / $11.64 / $13.33	Facility	26	$6.30	$11.64	$13.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.25 / $237.56 / $263.50	Facility	TC	$28.25	$237.56	$263.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.76 / $35.89 / $134.10	Professional		$21.76	$35.89	$134.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.22 / $36.09	Professional	26	$7.33	$9.22	$36.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.86 / $15.86 / $15.86	Professional	50	$15.86	$15.86	$15.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.87 / $26.62 / $58.57	Professional	TC	$19.87	$26.62	$58.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.76 / $31.76 / $31.76	Professional		$31.76	$31.76	$31.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $7.94 / $17.14	Professional	26	$6.74	$7.94	$17.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.01 / $308.22 / $531.83	Facility		$89.01	$308.22	$531.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.02 / $22.57 / $40.47	Professional		$6.02	$22.57	$40.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.42 / $22.42 / $22.42	Facility		$22.42	$22.42	$22.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.88 / $42.74 / $61.97	Professional		$27.88	$42.74	$61.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.35 / $10.90 / $15.56	Professional	26	$7.35	$10.90	$15.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.22 / $31.66 / $46.05	Professional	TC	$20.22	$31.66	$46.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.31 / $32.34 / $38.29	Professional		$10.31	$32.34	$38.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.71 / $41.39 / $51.68	Facility		$25.71	$41.39	$51.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.88 / $51.75 / $71.80	Professional		$32.88	$51.75	$71.80
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $10.99 / $15.22	Professional	26	$7.36	$10.99	$15.22
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.18 / $31.84 / $46.05	Professional	TC	$20.18	$31.84	$46.05
United Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $34.39 / $67.65	Professional		$31.40	$34.39	$67.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $9.02 / $19.76	Professional	26	$8.41	$9.02	$19.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.38 / $25.46 / $50.92	Professional	TC	$22.38	$25.46	$50.92