Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.97 / $156.15 / $178.75	Facility	26	$100.97	$156.15	$178.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.19 / $475.00 / $974.28	Professional		$309.19	$475.00	$974.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.97 / $140.00 / $498.00	Professional	26	$100.97	$140.00	$498.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $154.60 / $350.00 / $350.00	Professional	52	$154.60	$350.00	$350.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.89 / $335.00 / $688.86	Professional	TC	$223.89	$335.00	$688.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $315.87 / $315.87 / $315.87	Professional		$315.87	$315.87	$315.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $87.62 / $95.58 / $153.05	Professional	26	$87.62	$95.58	$153.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.47 / $224.95 / $452.98	Professional		$77.47	$224.95	$452.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.98 / $798.10 / $1,169.05	Professional		$325.98	$798.10	$1,169.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.61 / $151.33 / $215.58	Professional	26	$94.61	$151.33	$215.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.00 / $664.23 / $953.47	Professional	TC	$218.00	$664.23	$953.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $134.02 / $381.38	Professional		$32.34	$134.02	$381.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $429.07 / $793.59 / $1,075.70	Professional		$429.07	$793.59	$1,075.70
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $98.20 / $152.36 / $197.89	Professional	26	$98.20	$152.36	$197.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $218.00 / $664.23 / $953.47	Professional	TC	$218.00	$664.23	$953.47
United Facility/Professional Professional Modifier Low / Median / High Price $315.04 / $722.75 / $1,331.18	Professional		$315.04	$722.75	$1,331.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.88 / $102.09 / $264.66	Professional	26	$96.88	$102.09	$264.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.34 / $518.38 / $992.24	Professional	TC	$215.34	$518.38	$992.24