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 / $283.05	Facility	26	$41.81	$85.58	$283.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.81 / $221.44 / $418.76	Professional		$95.81	$221.44	$418.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $51.57 / $151.63	Professional	26	$43.82	$51.57	$151.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.50 / $177.61 / $221.14	Professional	TC	$75.50	$177.61	$221.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.47 / $41.22 / $44.47	Professional	26	$35.47	$41.22	$44.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.78 / $91.33 / $163.72	Professional		$33.78	$91.33	$163.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.34 / $271.04 / $413.91	Professional		$133.34	$271.04	$413.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $65.41 / $92.47	Professional	26	$41.27	$65.41	$92.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.67 / $213.17 / $315.13	Professional	TC	$83.67	$213.17	$315.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $57.77 / $155.25	Professional		$32.34	$57.77	$155.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $174.87 / $297.36 / $392.98	Professional		$174.87	$297.36	$392.98
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $43.01 / $67.09 / $86.02	Professional	26	$43.01	$67.09	$86.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $91.31 / $213.17 / $321.44	Professional	TC	$91.31	$213.17	$321.44
United Facility/Professional Professional Modifier Low / Median / High Price $133.75 / $229.62 / $391.60	Professional		$133.75	$229.62	$391.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.56 / $51.25 / $112.96	Professional	26	$43.56	$51.25	$112.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.19 / $182.41 / $268.99	Professional	TC	$90.19	$182.41	$268.99