Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.89 / $323.00 / $632.62	Facility		$98.89	$323.00	$632.62
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.35 / $37.84 / $43.33	Facility	26	$20.35	$37.84	$43.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $134.79 / $468.15	Professional		$107.34	$134.79	$468.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $34.65 / $148.00	Professional	26	$24.07	$34.65	$148.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $41.85 / $67.40 / $337.21	Professional	52	$41.85	$67.40	$337.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.28 / $100.13 / $501.61	Professional	TC	$83.28	$100.13	$501.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.79 / $77.79 / $106.30	Professional		$77.79	$77.79	$106.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.82 / $37.82 / $41.38	Professional	26	$37.82	$37.82	$41.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $145.94 / $508.46 / $871.96	Facility		$145.94	$508.46	$871.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $75.28 / $129.05	Professional		$19.05	$75.28	$129.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.47 / $79.47 / $79.47	Facility		$79.47	$79.47	$79.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.24 / $140.15 / $200.66	Professional		$94.24	$140.15	$200.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $35.75 / $49.51	Professional	26	$23.25	$35.75	$49.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.95 / $106.82 / $154.03	Professional	TC	$69.95	$106.82	$154.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $38.85 / $139.91	Professional		$32.34	$38.85	$139.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $86.57 / $117.42 / $160.87	Facility		$86.57	$117.42	$160.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $96.28 / $182.03 / $270.61	Professional		$96.28	$182.03	$270.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $37.58 / $49.51	Professional	26	$24.28	$37.58	$49.51
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $69.95 / $114.38 / $147.76	Professional	TC	$69.95	$114.38	$147.76
United Facility/Professional Facility Modifier Low / Median / High Price $143.63 / $143.63 / $235.69	Facility		$143.63	$143.63	$235.69
United Facility/Professional Professional Modifier Low / Median / High Price $109.64 / $118.01 / $232.16	Professional		$109.64	$118.01	$232.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.77 / $28.87 / $56.80	Professional	26	$27.77	$28.87	$56.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.87 / $90.08 / $175.36	Professional	TC	$81.87	$90.08	$175.36