Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $100.00 / $524.81	Facility		$38.90	$100.00	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $10.72 / $14.13	Facility	26	$9.77	$10.72	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $28.84 / $83.18	Facility	TC	$25.12	$28.84	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $30.90 / $114.82	Professional		$13.18	$30.90	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $12.02 / $38.02	Professional	26	$6.03	$12.02	$38.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $144.54 / $288.40	Professional	50	$50.12	$144.54	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $72.44	Professional	TC	$15.14	$22.91	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.50 / $21.88	Professional		$16.60	$19.50	$21.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.13 / $14.13	Professional	TC	$14.13	$14.13	$14.13
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 $5.50 / $19.95 / $33.88	Professional		$5.50	$19.95	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $50.12	Professional		$24.55	$35.48	$50.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.00 / $14.79	Professional	26	$6.46	$10.00	$14.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $24.55 / $36.31	Professional	TC	$17.78	$24.55	$36.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $32.36 / $33.11	Professional		$13.80	$32.36	$33.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $38.02 / $61.66	Facility		$27.54	$38.02	$61.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $43.65 / $66.07	Professional		$25.70	$43.65	$66.07
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.47 / $14.79	Professional	26	$6.76	$10.47	$14.79
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.92 / $36.31	Professional	TC	$19.05	$26.92	$36.31
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 $26.92 / $29.51 / $54.95	Professional		$26.92	$29.51	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.71 / $16.60	Professional	26	$7.59	$8.71	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $20.42 / $39.81	Professional	TC	$18.62	$20.42	$39.81