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 / $752.37	Professional		$225.85	$431.44	$752.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.93 / $87.92 / $324.72	Professional	26	$72.93	$87.92	$324.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.93 / $346.05 / $552.10	Professional	TC	$152.93	$346.05	$552.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.42 / $78.20 / $168.42	Professional	26	$66.42	$78.20	$168.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $193.68 / $351.63	Professional		$74.68	$193.68	$351.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.43 / $664.57 / $982.41	Professional		$264.43	$664.57	$982.41
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 $189.88 / $565.05 / $835.31	Professional	TC	$189.88	$565.05	$835.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $101.58 / $323.19	Professional		$32.34	$101.58	$323.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $370.14 / $660.69 / $896.75	Professional		$370.14	$660.69	$896.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $75.08 / $115.65 / $150.15	Professional	26	$75.08	$115.65	$150.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $189.88 / $565.05 / $862.67	Professional	TC	$189.88	$565.05	$862.67
United Facility/Professional Professional Modifier Low / Median / High Price $255.84 / $528.57 / $836.65	Professional		$255.84	$528.57	$836.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.84 / $81.55 / $195.93	Professional	26	$71.84	$81.55	$195.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.76 / $441.00 / $718.56	Professional	TC	$179.76	$441.00	$718.56