Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.81 / $85.58 / $300.05	Facility	26	$41.81	$85.58	$300.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.58 / $247.93 / $467.66	Professional		$120.58	$247.93	$467.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $51.92 / $190.03	Professional	26	$44.14	$51.92	$190.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.08 / $177.61 / $293.55	Professional	TC	$76.08	$177.61	$293.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.77 / $73.31 / $301.70	Professional	26	$37.77	$73.31	$301.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.78 / $91.78 / $193.19	Professional		$33.78	$91.78	$193.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.66 / $279.41 / $416.09	Professional		$133.66	$279.41	$416.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $65.31 / $97.52	Professional	26	$41.27	$65.31	$97.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.00 / $220.20 / $325.52	Professional	TC	$84.00	$220.20	$325.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $57.77 / $155.62	Professional		$32.34	$57.77	$155.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $175.29 / $306.20 / $393.96	Professional		$175.29	$306.20	$393.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $43.01 / $68.73 / $86.02	Professional	26	$43.01	$68.73	$86.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $91.93 / $220.20 / $329.21	Professional	TC	$91.93	$220.20	$329.21
United Facility/Professional Professional Modifier Low / Median / High Price $134.36 / $242.80 / $467.09	Professional		$134.36	$242.80	$467.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.32 / $50.28 / $119.28	Professional	26	$43.32	$50.28	$119.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.80 / $192.52 / $307.72	Professional	TC	$90.80	$192.52	$307.72