Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $478.63 / $812.83	Facility		$218.78	$478.63	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $48.98 / $144.54	Facility	26	$40.74	$48.98	$144.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $173.78 / $213.80 / $616.60	Facility	TC	$173.78	$213.80	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $234.42 / $912.01	Professional		$165.96	$234.42	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.90 / $162.18	Professional	26	$30.20	$38.90	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $173.78 / $426.58	Professional	TC	$134.90	$173.78	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $165.96 / $177.83	Professional		$144.54	$165.96	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Professional	26	$25.70	$25.70	$25.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	TC	$95.50	$95.50	$95.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $831.76 / $1,380.38	Facility		$338.84	$831.76	$1,380.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $125.89 / $213.80	Professional		$23.44	$125.89	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $144.54 / $234.42	Facility		$144.54	$144.54	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $407.38	Professional		$186.21	$281.84	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $43.65 / $61.66	Professional	26	$32.36	$43.65	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $245.47 / $346.74	Professional	TC	$151.36	$245.47	$346.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $257.04	Professional		$32.36	$33.11	$257.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $263.03 / $436.52	Facility		$186.21	$263.03	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $354.81 / $457.09	Professional		$208.93	$354.81	$457.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $47.86 / $61.66	Professional	26	$32.36	$47.86	$61.66
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $257.04 / $363.08	Professional	TC	$169.82	$257.04	$363.08
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,047.13 / $1,047.13	Facility		$467.74	$1,047.13	$1,047.13
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $446.68	Professional		$199.53	$331.13	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $50.12 / $67.61	Professional	26	$35.48	$50.12	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $281.84 / $389.05	Professional	TC	$162.18	$281.84	$389.05