Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $123.03 / $691.83	Facility		$56.23	$123.03	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $12.88 / $16.98	Facility	26	$11.48	$12.88	$16.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.15 / $56.23 / $234.42	Facility	TC	$37.15	$56.23	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $42.66 / $158.49	Professional		$9.12	$42.66	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.88 / $45.71	Professional	26	$7.08	$12.88	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.38 / $77.62 / $389.05	Professional	50	$17.38	$77.62	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $128.82	Professional	TC	$20.89	$33.88	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.18 / $50.12	Professional		$22.39	$28.18	$50.12
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $42.66 / $42.66	Professional	50	$42.66	$42.66	$42.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $21.88 / $50.12	Professional	TC	$21.88	$21.88	$50.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $512.86 / $851.14	Facility		$204.17	$512.86	$851.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $28.18 / $51.29	Professional		$6.46	$28.18	$51.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Facility		$29.51	$29.51	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $45.71 / $69.18	Professional		$33.11	$45.71	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $18.62	Professional	26	$7.94	$12.02	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $53.70	Professional	TC	$25.70	$33.11	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $33.11 / $45.71	Professional		$16.22	$33.11	$45.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $52.48 / $87.10	Facility		$34.67	$52.48	$87.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $57.54 / $91.20	Professional		$35.48	$57.54	$91.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $18.62	Professional	26	$8.13	$13.18	$18.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $35.48 / $50.12	Professional	TC	$25.70	$35.48	$50.12
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 $33.88 / $39.81 / $72.44	Professional		$33.88	$39.81	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.77 / $18.62	Professional	26	$8.71	$9.77	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $54.95	Professional	TC	$23.99	$30.20	$54.95