Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $204.17 / $389.05	Facility		$83.18	$204.17	$389.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $43.65 / $57.54	Facility	26	$40.74	$43.65	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $380.19	Professional		$54.95	$93.33	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $61.66 / $151.36	Professional	26	$26.92	$61.66	$151.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $234.42 / $645.65	Professional	50	$74.13	$234.42	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $58.88 / $257.04	Professional	TC	$41.69	$58.88	$257.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $77.62 / $79.43	Professional		$67.61	$77.62	$79.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $489.78 / $812.83	Facility		$199.53	$489.78	$812.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $58.88 / $97.72	Professional		$23.44	$58.88	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $141.25	Professional		$70.79	$102.33	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $39.81 / $57.54	Professional	26	$27.54	$39.81	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $63.10 / $85.11	Professional	TC	$43.65	$63.10	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $97.72	Professional		$32.36	$33.11	$97.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $112.20 / $190.55	Facility		$70.79	$112.20	$190.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $123.03 / $194.98	Professional		$72.44	$123.03	$194.98
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $40.74 / $57.54	Professional	26	$28.84	$40.74	$57.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $61.66 / $85.11	Professional	TC	$43.65	$61.66	$85.11
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 $85.11 / $102.33 / $173.78	Professional		$85.11	$102.33	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $39.81 / $67.61	Professional	26	$33.11	$39.81	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $63.10 / $107.15	Professional	TC	$52.48	$63.10	$107.15