Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $79.43 / $302.00	Facility		$39.81	$79.43	$302.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $12.02 / $15.85	Facility	26	$10.96	$12.02	$15.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $36.31 / $234.42	Facility	TC	$25.12	$36.31	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $36.31 / $109.65	Professional		$21.88	$36.31	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.77 / $38.90	Professional	26	$7.08	$9.77	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $70.79	Professional	TC	$15.14	$22.91	$70.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $19.95 / $24.55	Professional		$16.98	$19.95	$24.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $6.76 / $6.76	Professional	26	$6.76	$6.76	$6.76
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.13 / $15.85	Professional	TC	$14.13	$14.13	$15.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $331.13 / $562.34	Facility		$134.90	$331.13	$562.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $20.89 / $35.48	Professional		$6.31	$20.89	$35.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $51.29	Professional		$24.55	$35.48	$51.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $11.22 / $16.60	Professional	26	$7.41	$11.22	$16.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.91 / $35.48	Professional	TC	$16.60	$22.91	$35.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $32.36 / $33.88	Professional		$15.49	$32.36	$33.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $37.15 / $63.10	Facility		$23.99	$37.15	$63.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $41.69 / $67.61	Professional		$26.30	$41.69	$67.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.48 / $16.60	Professional	26	$7.59	$11.48	$16.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.91 / $30.20	Professional	TC	$16.60	$22.91	$30.20
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 $26.30 / $29.51 / $57.54	Professional		$26.30	$29.51	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.77 / $18.20	Professional	26	$8.91	$9.77	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $20.42 / $38.90	Professional	TC	$17.38	$20.42	$38.90