Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.15 / $10.15 / $21.28	Facility	26	$10.15	$10.15	$21.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.20 / $23.20 / $46.05	Facility	TC	$23.20	$23.20	$46.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.35 / $47.25 / $115.41	Professional		$33.35	$47.25	$115.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $15.33 / $46.34	Professional	26	$10.15	$15.33	$46.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.20 / $32.27 / $58.83	Professional	TC	$23.20	$32.27	$58.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.52 / $43.52 / $43.52	Professional		$43.52	$43.52	$43.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.61 / $30.62 / $67.31	Professional		$9.61	$30.62	$67.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $59.45 / $86.80	Professional		$37.60	$59.45	$86.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $19.70 / $27.90	Professional	26	$12.17	$19.70	$27.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.08 / $38.11 / $55.61	Professional	TC	$26.08	$38.11	$55.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.67 / $32.34 / $52.47	Professional		$17.67	$32.34	$52.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.28 / $75.52 / $100.06	Professional		$43.28	$75.52	$100.06
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.13 / $20.52 / $27.90	Professional	26	$13.13	$20.52	$27.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $26.32 / $40.22 / $55.61	Professional	TC	$26.32	$40.22	$55.61
United Facility/Professional Professional Modifier Low / Median / High Price $44.75 / $50.02 / $107.12	Professional		$44.75	$50.02	$107.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.80 / $16.95 / $38.71	Professional	26	$14.80	$16.95	$38.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.95 / $33.72 / $67.62	Professional	TC	$29.95	$33.72	$67.62