Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.64 / $481.84 / $945.64	Facility		$105.64	$481.84	$945.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.96 / $44.95 / $109.65	Facility	26	$35.96	$44.95	$109.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $70.43 / $381.40 / $440.80	Facility	TC	$70.43	$381.40	$440.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $107.68 / $420.23	Professional		$92.70	$107.68	$420.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $32.59 / $115.78	Professional	26	$21.12	$32.59	$115.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.27 / $80.89 / $362.53	Professional	TC	$49.27	$80.89	$362.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $62.01 / $62.01	Professional		$62.01	$62.01	$62.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.02 / $22.43 / $56.41	Professional	26	$21.02	$22.43	$56.41
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 $19.80 / $59.75 / $105.87	Professional		$19.80	$59.75	$105.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.91 / $55.91 / $55.91	Facility		$55.91	$55.91	$55.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $123.46 / $174.90	Professional		$78.45	$123.46	$174.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.42 / $37.11 / $51.38	Professional	26	$24.42	$37.11	$51.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.07 / $88.55 / $125.87	Professional	TC	$52.07	$88.55	$125.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $40.32 / $110.11	Professional		$32.34	$40.32	$110.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $78.45 / $115.76 / $151.94	Facility		$78.45	$115.76	$151.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $82.31 / $154.32 / $211.99	Professional		$82.31	$154.32	$211.99
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.20 / $38.94 / $51.38	Professional	26	$25.20	$38.94	$51.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $52.07 / $88.85 / $125.87	Professional	TC	$52.07	$88.85	$125.87
United Facility/Professional Facility Modifier Low / Median / High Price $235.69 / $235.69 / $235.69	Facility		$235.69	$235.69	$235.69
United Facility/Professional Professional Modifier Low / Median / High Price $92.75 / $108.81 / $182.47	Professional		$92.75	$108.81	$182.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.22 / $31.27 / $65.56	Professional	26	$29.22	$31.27	$65.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.80 / $77.54 / $123.55	Professional	TC	$62.80	$77.54	$123.55