Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.52 / $156.15 / $178.75	Facility	26	$59.52	$156.15	$178.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.43 / $475.00 / $1,495.17	Professional		$269.43	$475.00	$1,495.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.00 / $140.00 / $322.00	Professional	26	$64.00	$140.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.95 / $335.00 / $596.05	Professional	TC	$169.95	$335.00	$596.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $219.78 / $219.78 / $219.78	Professional		$219.78	$219.78	$219.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $129.93 / $129.93 / $129.93	Professional	26	$129.93	$129.93	$129.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.62 / $157.16 / $321.08	Professional		$45.62	$157.16	$321.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.30 / $557.46 / $824.07	Professional		$229.30	$557.46	$824.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.71 / $86.36 / $123.11	Professional	26	$55.71	$86.36	$123.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.85 / $481.07 / $711.14	Professional	TC	$165.85	$481.07	$711.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $78.43 / $314.12	Professional		$32.34	$78.43	$314.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $297.58 / $557.46 / $751.36	Professional		$297.58	$557.46	$751.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $57.98 / $92.81 / $123.11	Professional	26	$57.98	$92.81	$123.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $165.85 / $481.07 / $712.73	Professional	TC	$165.85	$481.07	$712.73
United Facility/Professional Professional Modifier Low / Median / High Price $222.40 / $467.20 / $779.70	Professional		$222.40	$467.20	$779.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $58.59 / $151.66	Professional	26	$54.76	$58.59	$151.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.81 / $375.80 / $657.58	Professional	TC	$163.81	$375.80	$657.58