Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.86 / $647.02 / $2,217.76	Facility		$295.86	$647.02	$2,217.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.35 / $107.22 / $584.58	Facility	26	$56.35	$107.22	$584.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.98 / $270.93 / $867.00	Professional		$173.98	$270.93	$867.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.44 / $74.87 / $255.70	Professional	26	$63.44	$74.87	$255.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.49 / $175.12 / $238.11	Professional	TC	$106.49	$175.12	$238.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.40 / $138.54 / $138.54	Professional	26	$50.40	$138.54	$138.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $676.46 / $2,356.86 / $4,041.82	Facility		$676.46	$2,356.86	$4,041.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.63 / $135.06 / $256.56	Professional		$48.63	$135.06	$256.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.89 / $303.85 / $378.97	Professional		$217.89	$303.85	$378.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.17 / $94.97 / $120.83	Professional	26	$73.17	$94.97	$120.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.19 / $211.15 / $260.51	Professional	TC	$141.19	$211.15	$260.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $104.35 / $286.20	Professional		$32.34	$104.35	$286.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $175.59 / $257.45 / $503.70	Facility		$175.59	$257.45	$503.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $222.22 / $341.05 / $455.22	Professional		$222.22	$341.05	$455.22
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $73.17 / $96.45 / $120.83	Professional	26	$73.17	$96.45	$120.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $141.52 / $203.33 / $260.51	Professional	TC	$141.52	$203.33	$260.51
United Facility/Professional Professional Modifier Low / Median / High Price $234.40 / $360.15 / $473.76	Professional		$234.40	$360.15	$473.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.20 / $109.45 / $146.38	Professional	26	$83.20	$109.45	$146.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.19 / $260.64 / $336.65	Professional	TC	$151.19	$260.64	$336.65