Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $107.15 / $281.84	Facility		$54.95	$107.15	$281.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $14.79 / $15.49	Facility	26	$13.49	$14.79	$15.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $42.66 / $117.49	Facility	TC	$40.74	$42.66	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $147.91	Professional		$30.20	$42.66	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $43.65	Professional	26	$7.94	$12.02	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $186.21 / $204.17	Professional	50	$50.12	$186.21	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $29.51 / $77.62	Professional	TC	$20.89	$29.51	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $28.18 / $32.36	Professional		$23.99	$28.18	$32.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	TC	$31.62	$31.62	$31.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $537.03 / $912.01	Facility		$218.78	$537.03	$912.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $28.18 / $47.86	Professional		$8.91	$28.18	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Facility		$28.18	$28.18	$28.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $46.77 / $70.79	Professional		$33.88	$46.77	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.80 / $20.89	Professional	26	$9.12	$13.80	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.88 / $51.29	Professional	TC	$24.55	$33.88	$51.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $33.11 / $46.77	Professional		$19.05	$33.11	$46.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $51.29 / $87.10	Facility		$33.88	$51.29	$87.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $57.54 / $93.33	Professional		$36.31	$57.54	$93.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.79 / $20.89	Professional	26	$9.33	$14.79	$20.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $35.48 / $46.77	Professional	TC	$25.12	$35.48	$46.77
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 $38.02 / $41.69 / $79.43	Professional		$38.02	$41.69	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.59 / $22.39	Professional	26	$11.22	$12.59	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $29.51 / $56.23	Professional	TC	$26.30	$29.51	$56.23