Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.93 / $149.38 / $171.00	Facility	26	$72.93	$149.38	$171.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $225.85 / $431.44 / $754.28	Professional		$225.85	$431.44	$754.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.93 / $88.35 / $324.72	Professional	26	$72.93	$88.35	$324.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.93 / $351.12 / $554.03	Professional	TC	$152.93	$351.12	$554.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.42 / $72.47 / $78.20	Professional	26	$66.42	$72.47	$78.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.13 / $193.91 / $356.59	Professional		$59.13	$193.91	$356.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.74 / $653.47 / $917.09	Professional		$264.74	$653.47	$917.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.22 / $112.49 / $160.06	Professional	26	$72.22	$112.49	$160.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.19 / $553.96 / $770.73	Professional	TC	$190.19	$553.96	$770.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $101.58 / $323.58	Professional		$32.34	$101.58	$323.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $355.62 / $653.47 / $880.76	Professional		$355.62	$653.47	$880.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $75.08 / $112.49 / $150.15	Professional	26	$75.08	$112.49	$150.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $190.19 / $553.96 / $836.38	Professional	TC	$190.19	$553.96	$836.38
United Facility/Professional Professional Modifier Low / Median / High Price $256.14 / $526.30 / $745.20	Professional		$256.14	$526.30	$745.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.73 / $76.34 / $195.93	Professional	26	$71.73	$76.34	$195.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.07 / $451.84 / $700.01	Professional	TC	$180.07	$451.84	$700.01