Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.07 / $187.00 / $504.80	Facility		$46.07	$187.00	$504.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.05 / $11.21 / $28.05	Facility	26	$6.05	$11.21	$28.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.83 / $263.50 / $809.62	Facility	TC	$33.83	$263.50	$809.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.33 / $38.44 / $131.96	Professional		$21.33	$38.44	$131.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.43 / $40.00	Professional	26	$7.33	$9.43	$40.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.66 / $63.66 / $76.40	Professional	50	$63.66	$63.66	$76.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.77 / $20.63 / $20.63	Professional	52	$12.77	$20.63	$20.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $26.58 / $57.14	Professional	TC	$21.32	$26.58	$57.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $33.04 / $66.84	Professional		$33.04	$33.04	$66.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $6.76 / $11.34	Professional	26	$6.49	$6.76	$11.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.01 / $300.00 / $531.83	Facility		$89.01	$300.00	$531.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.76 / $23.46 / $44.44	Professional		$6.76	$23.46	$44.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.59 / $24.59 / $24.59	Facility		$24.59	$24.59	$24.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $39.81 / $57.79	Professional		$28.69	$39.81	$57.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $10.90 / $14.96	Professional	26	$7.06	$10.90	$14.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $29.21 / $42.47	Professional	TC	$21.88	$29.21	$42.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.93 / $32.34 / $39.82	Professional		$9.93	$32.34	$39.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $26.75 / $37.63 / $50.46	Facility		$26.75	$37.63	$50.46
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $49.00 / $76.38	Professional		$30.51	$49.00	$76.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.07 / $10.91 / $14.66	Professional	26	$7.07	$10.91	$14.66
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $31.13 / $42.47	Professional	TC	$21.38	$31.13	$42.47
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 $29.94 / $33.20 / $72.90	Professional		$29.94	$33.20	$72.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $8.66 / $18.98	Professional	26	$8.34	$8.66	$18.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.28 / $24.54 / $51.30	Professional	TC	$21.28	$24.54	$51.30