Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.61 / $72.78 / $83.31	Facility	26	$35.61	$72.78	$83.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.16 / $253.19 / $784.76	Professional		$147.16	$253.19	$784.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.65 / $57.85 / $187.87	Professional	26	$36.65	$57.85	$187.87
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $57.89 / $103.58 / $103.58	Professional	52	$57.89	$103.58	$103.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.98 / $196.69 / $251.00	Professional	TC	$81.98	$196.69	$251.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.74 / $126.74 / $126.74	Professional		$126.74	$126.74	$126.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.65 / $38.44 / $62.75	Professional	26	$32.65	$38.44	$62.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.92 / $90.04 / $165.73	Professional		$28.92	$90.04	$165.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.40 / $289.38 / $429.58	Professional		$124.40	$289.38	$429.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.75 / $67.16 / $94.01	Professional	26	$37.75	$67.16	$94.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.29 / $225.01 / $332.63	Professional	TC	$86.29	$225.01	$332.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $49.93 / $152.75	Professional		$32.34	$49.93	$152.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $171.86 / $289.38 / $391.79	Professional		$171.86	$289.38	$391.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $67.18 / $95.15	Professional	26	$40.54	$67.18	$95.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $86.29 / $225.01 / $342.95	Professional	TC	$86.29	$225.01	$342.95
United Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $238.51 / $354.60	Professional		$120.25	$238.51	$354.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.43 / $49.36 / $106.15	Professional	26	$37.43	$49.36	$106.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.82 / $187.14 / $287.00	Professional	TC	$82.82	$187.14	$287.00