Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.30 / $109.30 / $125.13	Facility	26	$53.30	$109.30	$125.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.18 / $283.83 / $490.78	Professional		$158.18	$283.83	$490.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.30 / $66.47 / $279.51	Professional	26	$53.30	$66.47	$279.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.88 / $226.80 / $313.58	Professional	TC	$104.88	$226.80	$313.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.81 / $171.81 / $171.81	Professional		$171.81	$171.81	$171.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.41 / $122.44 / $229.93	Professional		$50.41	$122.44	$229.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.98 / $341.90 / $459.60	Professional		$170.98	$341.90	$459.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.75 / $81.52 / $116.05	Professional	26	$52.75	$81.52	$116.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.78 / $269.79 / $351.90	Professional	TC	$111.78	$269.79	$351.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $73.93 / $207.40	Professional		$32.34	$73.93	$207.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $233.42 / $356.77 / $492.20	Professional		$233.42	$356.77	$492.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $54.93 / $84.14 / $109.87	Professional	26	$54.93	$84.14	$109.87
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $111.78 / $269.79 / $351.90	Professional	TC	$111.78	$269.79	$351.90
United Facility/Professional Professional Modifier Low / Median / High Price $165.04 / $298.27 / $485.99	Professional		$165.04	$298.27	$485.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.86 / $55.22 / $142.19	Professional	26	$51.86	$55.22	$142.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.82 / $235.44 / $322.20	Professional	TC	$109.82	$235.44	$322.20