Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.31 / $224.40 / $429.19	Facility		$81.31	$224.40	$429.19
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.79 / $10.73 / $27.20	Facility	26	$5.79	$10.73	$27.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.50 / $30.42 / $235.02	Facility	TC	$17.50	$30.42	$235.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $30.49 / $127.00	Professional		$18.57	$30.49	$127.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $8.52 / $36.96	Professional	26	$6.49	$8.52	$36.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $87.26 / $87.26 / $87.26	Professional	50	$87.26	$87.26	$87.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $21.53 / $53.91	Professional	TC	$17.57	$21.53	$53.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $30.78 / $30.78	Professional		$30.78	$30.78	$30.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $6.78 / $40.60	Professional	26	$6.22	$6.78	$40.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.01 / $310.12 / $531.83	Facility		$89.01	$310.12	$531.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.55 / $21.66 / $38.83	Professional		$5.55	$21.66	$38.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.11 / $22.11 / $22.11	Facility		$22.11	$22.11	$22.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $34.79 / $50.62	Professional		$26.46	$34.79	$50.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.90 / $14.33	Professional	26	$6.77	$10.90	$14.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $25.73 / $35.79	Professional	TC	$19.80	$25.73	$35.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.52 / $32.34 / $37.11	Professional		$9.52	$32.34	$37.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.65 / $36.21 / $52.22	Facility		$24.65	$36.21	$52.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.15 / $44.38 / $70.27	Professional		$27.15	$44.38	$70.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.90 / $14.26	Professional	26	$6.77	$10.90	$14.26
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.22 / $25.73 / $34.70	Professional	TC	$19.22	$25.73	$34.70
United Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $31.04 / $66.36	Professional		$26.69	$31.04	$66.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $8.66 / $19.76	Professional	26	$8.30	$8.66	$19.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.03 / $22.74 / $46.60	Professional	TC	$18.03	$22.74	$46.60