Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.80 / $151.24 / $424.88	Facility		$82.80	$151.24	$424.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.79 / $10.73 / $24.48	Facility	26	$5.79	$10.73	$24.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.00 / $31.27 / $35.79	Facility	TC	$18.00	$31.27	$35.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.79 / $30.50 / $142.10	Professional		$23.79	$30.50	$142.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.22 / $35.00	Professional	26	$7.03	$8.22	$35.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.90 / $19.23 / $19.23	Professional	52	$11.90	$19.23	$19.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $22.05 / $44.96	Professional	TC	$18.00	$22.05	$44.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.96 / $59.96 / $59.96	Professional		$59.96	$59.96	$59.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $6.22 / $6.22	Professional	26	$6.22	$6.22	$6.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.47 / $496.38 / $851.26	Facility		$142.47	$496.38	$851.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.55 / $22.10 / $39.63	Professional		$5.55	$22.10	$39.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.73 / $22.73 / $22.73	Facility		$22.73	$22.73	$22.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.29 / $35.60 / $52.95	Professional		$27.29	$35.60	$52.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.46 / $14.90	Professional	26	$6.77	$10.46	$14.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.12 / $25.75 / $37.69	Professional	TC	$20.12	$25.75	$37.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $32.34 / $37.49	Professional		$9.55	$32.34	$37.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $24.48 / $34.27 / $47.06	Facility		$24.48	$34.27	$47.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $46.43 / $72.56	Professional		$27.72	$46.43	$72.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.49 / $14.04	Professional	26	$6.77	$10.49	$14.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $27.08 / $37.69	Professional	TC	$19.76	$27.08	$37.69
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 $26.33 / $32.11 / $69.52	Professional		$26.33	$32.11	$69.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.71 / $8.66 / $19.44	Professional	26	$7.71	$8.66	$19.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $23.46 / $50.55	Professional	TC	$18.39	$23.46	$50.55