Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.73 / $136.04 / $383.52	Facility		$81.73	$136.04	$383.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.04 / $11.16 / $12.78	Facility	26	$6.04	$11.16	$12.78
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $38.24 / $293.24	Facility	TC	$30.58	$38.24	$293.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.94 / $33.65 / $118.41	Professional		$16.94	$33.65	$118.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.04 / $8.77 / $39.38	Professional	26	$6.04	$8.77	$39.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $208.50 / $208.50 / $208.50	Professional	50	$208.50	$208.50	$208.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.64 / $20.41 / $20.41	Professional	52	$12.64	$20.41	$20.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $24.25 / $100.00	Professional	TC	$19.46	$24.25	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.03 / $33.03 / $33.03	Professional		$33.03	$33.03	$33.03
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 $6.74 / $23.44 / $49.34	Professional		$6.74	$23.44	$49.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.28 / $24.28 / $24.28	Facility		$24.28	$24.28	$24.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.68 / $38.65 / $57.30	Professional		$28.68	$38.65	$57.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.29 / $11.75 / $16.02	Professional	26	$7.29	$11.75	$16.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $27.43 / $39.47	Professional	TC	$21.32	$27.43	$39.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.89 / $32.34 / $39.78	Professional		$9.89	$32.34	$39.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.98 / $36.69 / $58.75	Facility		$25.98	$36.69	$58.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.71 / $50.24 / $76.38	Professional		$29.71	$50.24	$76.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $11.75 / $16.02	Professional	26	$7.54	$11.75	$16.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $28.43 / $39.47	Professional	TC	$21.10	$28.43	$39.47
United Facility/Professional Facility Modifier Low / Median / High Price $194.81 / $194.81 / $194.81	Facility		$194.81	$194.81	$194.81
United Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $33.92 / $78.30	Professional		$27.77	$33.92	$78.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $9.53 / $22.13	Professional	26	$8.36	$9.53	$22.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.11 / $25.26 / $52.92	Professional	TC	$19.11	$25.26	$52.92