Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $199.53 / $446.68	Facility		$41.69	$199.53	$446.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $11.22 / $14.13	Facility	26	$9.77	$11.22	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $32.36 / $234.42	Facility	TC	$27.54	$32.36	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $33.11 / $131.83	Professional		$13.18	$33.11	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $12.02 / $39.81	Professional	26	$6.03	$12.02	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $120.23 / $275.42	Professional	50	$52.48	$120.23	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $25.12 / $97.72	Professional	TC	$15.49	$25.12	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $20.42 / $24.55	Professional		$17.38	$20.42	$24.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $15.85 / $23.44	Professional	TC	$15.85	$15.85	$23.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $316.23 / $537.03	Facility		$128.82	$316.23	$537.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $21.88 / $37.15	Professional		$5.50	$21.88	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $21.88 / $21.88	Facility		$21.88	$21.88	$21.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $34.67 / $53.70	Professional		$26.30	$34.67	$53.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.72 / $15.85	Professional	26	$6.76	$10.72	$15.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.12 / $39.81	Professional	TC	$19.05	$25.12	$39.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $32.36 / $35.48	Professional		$13.80	$32.36	$35.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $40.74 / $66.07	Facility		$28.84	$40.74	$66.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $44.67 / $70.79	Professional		$27.54	$44.67	$70.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.96 / $15.85	Professional	26	$6.76	$10.96	$15.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $25.70 / $34.67	Professional	TC	$19.50	$25.70	$34.67
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 $26.92 / $30.90 / $57.54	Professional		$26.92	$30.90	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.71 / $16.22	Professional	26	$8.32	$8.71	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $41.69	Professional	TC	$18.20	$22.91	$41.69