Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.73 / $156.15 / $407.84	Facility	26	$65.73	$156.15	$407.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.06 / $475.00 / $700.00	Professional		$185.06	$475.00	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.68 / $140.00 / $257.60	Professional	26	$70.68	$140.00	$257.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $92.53 / $350.00 / $350.00	Professional	52	$92.53	$350.00	$350.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.32 / $335.00 / $557.00	Professional	TC	$119.32	$335.00	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $188.89 / $188.89 / $188.89	Professional		$188.89	$188.89	$188.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.21 / $135.01 / $242.03	Professional		$50.21	$135.01	$242.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.34 / $514.03 / $759.87	Professional		$194.34	$514.03	$759.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.34 / $102.16 / $146.69	Professional	26	$63.34	$102.16	$146.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.21 / $422.97 / $624.91	Professional	TC	$124.21	$422.97	$624.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $86.31 / $228.18	Professional		$32.34	$86.31	$228.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $256.91 / $472.03 / $692.82	Professional		$256.91	$472.03	$692.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $64.06 / $102.93 / $146.69	Professional	26	$64.06	$102.93	$146.69
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $124.21 / $422.97 / $624.91	Professional	TC	$124.21	$422.97	$624.91
United Facility/Professional Professional Modifier Low / Median / High Price $187.43 / $443.29 / $817.15	Professional		$187.43	$443.29	$817.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.73 / $68.98 / $180.12	Professional	26	$64.73	$68.98	$180.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.70 / $322.45 / $545.50	Professional	TC	$122.70	$322.45	$545.50