Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.13 / $159.60 / $391.98	Facility		$84.13	$159.60	$391.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.54 / $10.30 / $11.80	Facility	26	$5.54	$10.30	$11.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.27 / $26.57 / $246.50	Facility	TC	$15.27	$26.57	$246.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.82 / $30.16 / $130.94	Professional		$20.82	$30.16	$130.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $7.83 / $34.00	Professional	26	$6.71	$7.83	$34.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.41 / $16.89 / $79.83	Professional	52	$10.41	$16.89	$79.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $21.30 / $39.29	Professional	TC	$16.48	$21.30	$39.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.57 / $27.57 / $27.57	Professional		$27.57	$27.57	$27.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.97 / $40.60 / $40.60	Professional	26	$5.97	$40.60	$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 $5.33 / $19.64 / $36.14	Professional		$5.33	$19.64	$36.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.32 / $19.32 / $19.32	Facility		$19.32	$19.32	$19.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.69 / $34.35 / $49.97	Professional		$23.69	$34.35	$49.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $10.03 / $13.73	Professional	26	$6.47	$10.03	$13.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.61 / $25.11 / $35.90	Professional	TC	$17.61	$25.11	$35.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.13 / $32.34 / $33.29	Professional		$9.13	$32.34	$33.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $22.32 / $34.27 / $48.69	Facility		$22.32	$34.27	$48.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $43.07 / $63.40	Professional		$26.23	$43.07	$63.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $10.38 / $13.48	Professional	26	$6.49	$10.38	$13.48
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.61 / $25.26 / $35.90	Professional	TC	$17.61	$25.26	$35.90
United Facility/Professional Professional Modifier Low / Median / High Price $25.61 / $28.15 / $65.70	Professional		$25.61	$28.15	$65.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $7.94 / $17.39	Professional	26	$7.59	$7.94	$17.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $20.21 / $45.36	Professional	TC	$17.67	$20.21	$45.36