Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.89 / $374.00 / $1,343.20	Facility		$98.89	$374.00	$1,343.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.23 / $27.97 / $81.59	Facility	26	$17.23	$27.97	$81.59
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $109.43 / $296.95 / $381.40	Facility	TC	$109.43	$296.95	$381.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.69 / $130.50 / $544.00	Professional		$22.69	$130.50	$544.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $25.62 / $98.16	Professional	26	$17.23	$25.62	$98.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.33 / $109.43 / $243.09	Professional	TC	$88.33	$109.43	$243.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.44 / $114.44 / $114.44	Professional		$114.44	$114.44	$114.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $18.37 / $29.22	Professional	26	$18.37	$18.37	$29.22
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 $15.03 / $80.89 / $144.69	Professional		$15.03	$80.89	$144.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.97 / $91.97 / $91.97	Facility		$91.97	$91.97	$91.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.24 / $193.86 / $274.63	Professional		$129.24	$193.86	$274.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.94 / $30.57 / $40.26	Professional	26	$21.94	$30.57	$40.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.25 / $165.54 / $233.63	Professional	TC	$107.25	$165.54	$233.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.07 / $32.34 / $172.36	Professional		$30.07	$32.34	$172.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $108.41 / $172.62 / $241.91	Facility		$108.41	$172.62	$241.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $132.21 / $226.17 / $275.73	Professional		$132.21	$226.17	$275.73
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.08 / $31.52 / $38.75	Professional	26	$22.08	$31.52	$38.75
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $110.36 / $165.54 / $233.63	Professional	TC	$110.36	$165.54	$233.63
United Facility/Professional Professional Modifier Low / Median / High Price $137.60 / $219.02 / $294.41	Professional		$137.60	$219.02	$294.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.20 / $34.65 / $71.08	Professional	26	$25.20	$34.65	$71.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.55 / $194.71 / $256.74	Professional	TC	$111.55	$194.71	$256.74