Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.12 / $92.20 / $357.00	Facility	26	$45.12	$92.20	$357.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.33 / $221.75 / $415.21	Professional		$120.33	$221.75	$415.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $55.75 / $179.12	Professional	26	$44.14	$55.75	$179.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $60.17 / $108.15 / $108.15	Professional	52	$60.17	$108.15	$108.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.28 / $177.61 / $281.80	Professional	TC	$89.28	$177.61	$281.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.97 / $131.97 / $131.97	Professional		$131.97	$131.97	$131.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.04 / $44.78 / $325.50	Professional	26	$41.04	$44.78	$325.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.81 / $94.03 / $193.66	Professional		$42.81	$94.03	$193.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.04 / $277.89 / $419.89	Professional		$137.04	$277.89	$419.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.79 / $66.93 / $93.67	Professional	26	$44.79	$66.93	$93.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.01 / $218.72 / $323.33	Professional	TC	$83.01	$218.72	$323.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $62.76 / $159.47	Professional		$32.34	$62.76	$159.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $179.65 / $298.14 / $404.74	Professional		$179.65	$298.14	$404.74
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $46.34 / $70.34 / $92.67	Professional	26	$46.34	$70.34	$92.67
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $87.27 / $218.72 / $326.22	Professional	TC	$87.27	$218.72	$326.22
United Facility/Professional Professional Modifier Low / Median / High Price $136.51 / $248.00 / $417.14	Professional		$136.51	$248.00	$417.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.84 / $50.60 / $129.28	Professional	26	$43.84	$50.60	$129.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $191.91 / $287.74	Professional	TC	$86.20	$191.91	$287.74