Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.73 / $524.40 / $1,027.07	Facility		$177.73	$524.40	$1,027.07
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.82 / $53.15 / $60.85	Facility	26	$28.82	$53.15	$60.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.10 / $142.18 / $612.00	Professional		$89.10	$142.18	$612.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $48.68 / $183.00	Professional	26	$34.67	$48.68	$183.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.45 / $99.56 / $454.00	Professional	TC	$65.45	$99.56	$454.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.54 / $112.54 / $112.54	Professional		$112.54	$112.54	$112.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.60 / $33.60 / $36.26	Professional	26	$33.60	$33.60	$36.26
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 $27.27 / $79.98 / $145.08	Professional		$27.27	$79.98	$145.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.20 / $74.20 / $74.20	Facility		$74.20	$74.20	$74.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $162.74 / $230.33	Professional		$104.55	$162.74	$230.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $50.23 / $69.55	Professional	26	$33.72	$50.23	$69.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.31 / $115.10 / $163.06	Professional	TC	$68.31	$115.10	$163.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $54.57 / $145.76	Professional		$32.34	$54.57	$145.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $104.55 / $155.71 / $200.71	Facility		$104.55	$155.71	$200.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $108.39 / $203.24 / $283.45	Professional		$108.39	$203.24	$283.45
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $53.60 / $69.55	Professional	26	$34.11	$53.60	$69.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $68.31 / $115.10 / $163.06	Professional	TC	$68.31	$115.10	$163.06
United Facility/Professional Professional Modifier Low / Median / High Price $125.23 / $143.63 / $246.37	Professional		$125.23	$143.63	$246.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $42.53 / $90.86	Professional	26	$40.09	$42.53	$90.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.37 / $101.64 / $168.64	Professional	TC	$83.37	$101.64	$168.64