Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.81 / $118.35 / $135.47	Facility	26	$57.81	$118.35	$135.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.04 / $314.01 / $909.91	Professional		$172.04	$314.01	$909.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $78.81 / $254.79	Professional	26	$59.34	$78.81	$254.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.40 / $251.06 / $361.27	Professional	TC	$110.40	$251.06	$361.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.28 / $182.28 / $182.28	Professional		$182.28	$182.28	$182.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.36 / $415.80 / $415.80	Professional	26	$52.36	$415.80	$415.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $130.04 / $271.57	Professional		$46.80	$130.04	$271.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.23 / $341.76 / $525.91	Professional		$181.23	$341.76	$525.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.17 / $88.05 / $126.21	Professional	26	$57.17	$88.05	$126.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.45 / $263.87 / $399.70	Professional	TC	$117.45	$263.87	$399.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $80.08 / $220.05	Professional		$32.34	$80.08	$220.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $237.75 / $364.49 / $523.52	Professional		$237.75	$364.49	$523.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $59.48 / $88.05 / $118.95	Professional	26	$59.48	$88.05	$118.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $117.45 / $263.87 / $399.70	Professional	TC	$117.45	$263.87	$399.70
United Facility/Professional Professional Modifier Low / Median / High Price $174.85 / $283.58 / $495.90	Professional		$174.85	$283.58	$495.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.69 / $64.58 / $154.85	Professional	26	$56.69	$64.58	$154.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.72 / $222.57 / $334.50	Professional	TC	$114.72	$222.57	$334.50