Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.43 / $156.15 / $178.75	Facility	26	$65.43	$156.15	$178.75
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.86 / $37.86 / $175.00	Facility	53	$37.86	$37.86	$175.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.09 / $475.00 / $700.00	Professional		$206.09	$475.00	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.43 / $140.00 / $322.00	Professional	26	$65.43	$140.00	$322.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $94.68 / $350.00 / $350.00	Professional	52	$94.68	$350.00	$350.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.93 / $335.00 / $557.00	Professional	TC	$123.93	$335.00	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.66 / $194.66 / $194.66	Professional		$194.66	$194.66	$194.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.30 / $61.30 / $61.30	Professional	26	$61.30	$61.30	$61.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.57 / $138.80 / $276.77	Professional		$58.57	$138.80	$276.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.66 / $568.83 / $840.88	Professional		$199.66	$568.83	$840.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.30 / $94.61 / $134.58	Professional	26	$61.30	$94.61	$134.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.53 / $485.14 / $717.16	Professional	TC	$129.53	$485.14	$717.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $85.92 / $235.05	Professional		$32.34	$85.92	$235.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $264.61 / $488.91 / $766.69	Professional		$264.61	$488.91	$766.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $63.79 / $101.89 / $134.58	Professional	26	$63.79	$101.89	$134.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $129.53 / $485.14 / $717.16	Professional	TC	$129.53	$485.14	$717.16
United Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $484.12 / $874.79	Professional		$192.64	$484.12	$874.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.73 / $64.73 / $165.90	Professional	26	$60.73	$64.73	$165.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $351.23 / $589.92	Professional	TC	$127.91	$351.23	$589.92