Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $171.76 / $563.16 / $804.64	Facility		$171.76	$563.16	$804.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.93 / $225.62 / $425.56	Professional		$198.93	$225.62	$425.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.76 / $73.56 / $124.75	Professional	26	$67.76	$73.56	$124.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.18 / $152.06 / $254.00	Professional	TC	$131.18	$152.06	$254.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $161.22 / $161.22 / $161.22	Professional	26	$161.22	$161.22	$161.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.17 / $196.56 / $349.23	Professional		$72.17	$196.56	$349.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.22 / $270.10 / $368.77	Professional		$134.22	$270.10	$368.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.42 / $97.87 / $129.34	Professional	26	$67.42	$97.87	$129.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.69 / $187.70 / $239.42	Professional	TC	$153.69	$187.70	$239.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $115.63 / $399.78	Professional		$32.34	$115.63	$399.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $168.05 / $211.30 / $305.08	Facility		$168.05	$211.30	$305.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $249.94 / $347.74 / $757.51	Professional		$249.94	$347.74	$757.51
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $78.70 / $97.87 / $129.34	Professional	26	$78.70	$97.87	$129.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $159.88 / $191.40 / $239.42	Professional	TC	$159.88	$191.40	$239.42
United Facility/Professional Professional Modifier Low / Median / High Price $135.77 / $168.90 / $690.46	Professional		$135.77	$168.90	$690.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.38 / $51.97 / $138.59	Professional	26	$47.38	$51.97	$138.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.07 / $116.93 / $311.81	Professional	TC	$88.07	$116.93	$311.81