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 / $328.95	Facility	26	$41.81	$85.58	$328.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.32 / $247.93 / $467.66	Professional		$117.32	$247.93	$467.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $51.92 / $163.44	Professional	26	$44.14	$51.92	$163.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.50 / $177.61 / $276.17	Professional	TC	$75.50	$177.61	$276.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.22 / $301.70 / $301.70	Professional	26	$41.22	$301.70	$301.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.78 / $91.11 / $163.33	Professional		$33.78	$91.11	$163.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.02 / $277.02 / $413.99	Professional		$133.02	$277.02	$413.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $65.31 / $91.76	Professional	26	$41.27	$65.31	$91.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.34 / $219.09 / $323.88	Professional	TC	$83.34	$219.09	$323.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $57.77 / $154.86	Professional		$32.34	$57.77	$154.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $174.44 / $300.95 / $392.00	Professional		$174.44	$300.95	$392.00
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 $91.31 / $219.09 / $326.82	Professional	TC	$91.31	$219.09	$326.82
United Facility/Professional Professional Modifier Low / Median / High Price $133.75 / $241.88 / $454.50	Professional		$133.75	$241.88	$454.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.32 / $50.28 / $111.38	Professional	26	$43.32	$50.28	$111.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.19 / $191.60 / $325.80	Professional	TC	$90.19	$191.60	$325.80