Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.31 / $246.24 / $702.24	Facility		$81.31	$246.24	$702.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.80 / $12.53 / $30.60	Facility	26	$8.80	$12.53	$30.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.22 / $67.45 / $686.23	Facility	TC	$37.22	$67.45	$686.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.62 / $43.92 / $158.00	Professional		$21.62	$43.92	$158.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $10.11 / $43.00	Professional	26	$8.56	$10.11	$43.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $77.31 / $249.00	Professional	50	$19.27	$77.31	$249.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.13 / $24.36 / $24.36	Professional	52	$15.13	$24.36	$24.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $29.94 / $130.00	Professional	TC	$24.44	$29.94	$130.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.49 / $39.49 / $39.49	Professional		$39.49	$39.49	$39.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $8.56 / $18.48	Professional	26	$6.69	$8.56	$18.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.47 / $493.34 / $851.26	Facility		$142.47	$493.34	$851.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.57 / $27.94 / $57.27	Professional		$7.57	$27.94	$57.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.55 / $29.55 / $29.55	Facility		$29.55	$29.55	$29.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.44 / $46.20 / $68.09	Professional		$33.44	$46.20	$68.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $12.63 / $17.14	Professional	26	$8.07	$12.63	$17.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.66 / $33.09 / $49.64	Professional	TC	$25.66	$33.09	$49.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.12 / $32.34 / $47.50	Professional		$11.12	$32.34	$47.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.05 / $41.45 / $69.36	Facility		$31.05	$41.45	$69.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.11 / $59.00 / $90.13	Professional		$35.11	$59.00	$90.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $13.11 / $17.14	Professional	26	$8.07	$13.11	$17.14
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.46 / $35.64 / $49.64	Professional	TC	$25.46	$35.64	$49.64
United Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $39.70 / $89.10	Professional		$33.54	$39.70	$89.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $10.19 / $22.92	Professional	26	$9.10	$10.19	$22.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.16 / $29.96 / $65.68	Professional	TC	$24.16	$29.96	$65.68