Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $354.81 / $1,230.27	Facility		$138.04	$354.81	$1,230.27
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $38.90 / $48.98	Facility	26	$33.88	$38.90	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $125.89 / $501.19	Professional		$67.61	$125.89	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $33.88 / $154.88	Professional	26	$19.95	$33.88	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $95.50 / $389.05	Professional	TC	$58.88	$95.50	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $95.50	Professional		$85.11	$85.11	$95.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56,234.13 / $69,183.10 / $81,283.05	Facility		$56,234.13	$69,183.10	$81,283.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $63.10 / $138.04	Professional		$19.05	$63.10	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $100.00 / $199.53	Professional		$66.07	$100.00	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $32.36 / $63.10	Professional	26	$23.99	$32.36	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $74.13 / $151.36	Professional	TC	$40.74	$74.13	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $131.83	Professional		$32.36	$33.11	$131.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $120.23 / $251.19	Facility		$72.44	$120.23	$251.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $109.65 / $181.97	Professional		$66.07	$109.65	$181.97
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $38.02 / $63.10	Professional	26	$23.99	$38.02	$63.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $74.13 / $151.36	Professional	TC	$40.74	$74.13	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $87.10 / $186.21	Professional		$70.79	$87.10	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $27.54 / $54.95	Professional	26	$25.12	$27.54	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $56.23 / $134.90	Professional	TC	$43.65	$56.23	$134.90