Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.40 / $52.40 / $123.08	Facility	26	$52.40	$52.40	$123.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.56 / $347.48 / $427.97	Professional		$179.56	$347.48	$427.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.40 / $69.23 / $247.37	Professional	26	$52.40	$69.23	$247.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.16 / $288.12 / $353.66	Professional	TC	$127.16	$288.12	$353.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.92 / $193.92 / $193.92	Professional		$193.92	$193.92	$193.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.20 / $137.93 / $260.47	Professional		$42.20	$137.93	$260.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.78 / $421.11 / $636.42	Professional		$200.78	$421.11	$636.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.19 / $85.87 / $123.35	Professional	26	$54.19	$85.87	$123.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.19 / $342.68 / $506.57	Professional	TC	$138.19	$342.68	$506.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.70 / $254.82	Professional		$32.34	$72.70	$254.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $262.80 / $437.51 / $598.78	Professional		$262.80	$437.51	$598.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $54.19 / $85.87 / $115.15	Professional	26	$54.19	$85.87	$115.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $142.21 / $342.68 / $510.81	Professional	TC	$142.21	$342.68	$510.81
United Facility/Professional Professional Modifier Low / Median / High Price $200.32 / $358.99 / $654.61	Professional		$200.32	$358.99	$654.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.39 / $70.37 / $154.04	Professional	26	$56.39	$70.37	$154.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.51 / $299.20 / $439.79	Professional	TC	$140.51	$299.20	$439.79