Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.72 / $590.77 / $1,023.00	Facility		$122.72	$590.77	$1,023.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.57 / $31.57 / $71.63	Facility	26	$31.57	$31.57	$71.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.72 / $211.81 / $284.93	Professional		$122.72	$211.81	$284.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.57 / $57.30 / $210.38	Professional	26	$31.57	$57.30	$210.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.15 / $154.90 / $196.80	Professional	TC	$91.15	$154.90	$196.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.84 / $110.84 / $113.83	Professional		$110.84	$110.84	$113.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $244.62 / $896.97 / $1,461.60	Facility		$244.62	$896.97	$1,461.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.68 / $93.15 / $162.99	Professional		$36.68	$93.15	$162.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $189.54 / $253.03 / $330.96	Professional		$189.54	$253.03	$330.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.38 / $73.15 / $94.38	Professional	26	$55.38	$73.15	$94.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.36 / $177.27 / $237.45	Professional	TC	$128.36	$177.27	$237.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $55.96 / $186.45	Professional		$32.34	$55.96	$186.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $98.63 / $151.31 / $226.25	Facility		$98.63	$151.31	$226.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $167.90 / $253.03 / $371.17	Professional		$167.90	$253.03	$371.17
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $45.65 / $73.15 / $94.38	Professional	26	$45.65	$73.15	$94.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $111.74 / $174.60 / $223.49	Professional	TC	$111.74	$174.60	$223.49
United Facility/Professional Professional Modifier Low / Median / High Price $224.64 / $290.39 / $417.46	Professional		$224.64	$290.39	$417.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.83 / $80.37 / $118.49	Professional	26	$57.83	$80.37	$118.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.99 / $209.99 / $304.94	Professional	TC	$167.99	$209.99	$304.94