Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.32 / $156.15 / $178.75	Facility	26	$60.32	$156.15	$178.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.20 / $475.00 / $917.81	Professional		$200.20	$475.00	$917.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $140.00 / $273.00	Professional	26	$60.63	$140.00	$273.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.81 / $350.00 / $350.00	Professional	52	$97.81	$350.00	$350.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.49 / $335.00 / $557.00	Professional	TC	$145.49	$335.00	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.48 / $201.48 / $201.48	Professional		$201.48	$201.48	$201.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.53 / $90.41 / $131.21	Professional	26	$51.53	$90.41	$131.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.06 / $143.12 / $271.07	Professional		$46.06	$143.12	$271.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.18 / $536.45 / $746.37	Professional		$205.18	$536.45	$746.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.28 / $88.13 / $125.61	Professional	26	$56.28	$88.13	$125.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.38 / $458.50 / $637.91	Professional	TC	$140.38	$458.50	$637.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $78.81 / $242.94	Professional		$32.34	$78.81	$242.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $273.26 / $501.05 / $723.05	Professional		$273.26	$501.05	$723.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.91 / $93.48 / $125.61	Professional	26	$58.91	$93.48	$125.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $140.38 / $458.50 / $677.78	Professional	TC	$140.38	$458.50	$677.78
United Facility/Professional Professional Modifier Low / Median / High Price $198.48 / $452.49 / $654.91	Professional		$198.48	$452.49	$654.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $59.82 / $154.85	Professional	26	$54.76	$59.82	$154.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $330.11 / $537.14	Professional	TC	$138.66	$330.11	$537.14