Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $97.72 / $398.11	Facility		$45.71	$97.72	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $11.75 / $14.79	Facility	26	$10.23	$11.75	$14.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $44.67 / $467.74	Facility	TC	$30.90	$44.67	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $38.02 / $141.25	Professional		$8.51	$38.02	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $12.59 / $45.71	Professional	26	$6.03	$12.59	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $100.00 / $331.13	Professional	50	$34.67	$100.00	$331.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.80 / $3.80 / $3.80	Professional	52	$3.80	$3.80	$3.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $32.36 / $107.15	Professional	TC	$18.20	$32.36	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $22.91 / $26.30	Professional		$19.50	$22.91	$26.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $6.46 / $11.48	Professional	26	$6.46	$6.46	$11.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $28.18 / $33.11 / $45.71	Professional	50	$28.18	$33.11	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	TC	$16.22	$16.22	$16.22
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 $5.75 / $23.44 / $41.69	Professional		$5.75	$23.44	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $24.55	Facility		$24.55	$24.55	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $39.81 / $58.88	Professional		$28.84	$39.81	$58.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.47 / $15.49	Professional	26	$6.76	$10.47	$15.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.84 / $44.67	Professional	TC	$21.38	$28.84	$44.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $32.36 / $38.90	Professional		$14.45	$32.36	$38.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $44.67 / $70.79	Facility		$31.62	$44.67	$70.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $48.98 / $75.86	Professional		$30.20	$48.98	$75.86
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.96 / $15.49	Professional	26	$7.08	$10.96	$15.49
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $42.66	Professional	TC	$21.88	$30.90	$42.66
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 $30.20 / $33.11 / $61.66	Professional		$30.20	$33.11	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.71 / $16.60	Professional	26	$8.13	$8.71	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $24.55 / $45.71	Professional	TC	$21.38	$24.55	$45.71