Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $114.82 / $144.54	Facility	26	$87.10	$114.82	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $371.54 / $1,000.00	Professional		$131.83	$371.54	$1,000.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $138.04 / $380.19	Professional	26	$61.66	$138.04	$380.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $954.99 / $954.99 / $1,949.84	Professional	50	$954.99	$954.99	$1,949.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $1,023.29 / $1,023.29 / $1,023.29	Professional	52	$1,023.29	$1,023.29	$1,023.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $338.84 / $851.14	Professional	TC	$131.83	$338.84	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $138.04	Professional		$134.90	$134.90	$138.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $144.54 / $263.03	Professional		$45.71	$144.54	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $537.03 / $758.58	Professional		$194.98	$537.03	$758.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $125.89	Professional	26	$54.95	$85.11	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $457.09 / $645.65	Professional	TC	$138.04	$457.09	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $239.88	Professional		$32.36	$33.11	$239.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $501.19 / $741.31	Professional		$263.03	$501.19	$741.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $93.33 / $125.89	Professional	26	$60.26	$93.33	$125.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $467.74 / $645.65	Professional	TC	$165.96	$467.74	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $426.58 / $741.31	Professional		$199.53	$426.58	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $58.88 / $131.83	Professional	26	$54.95	$58.88	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $338.84 / $588.84	Professional	TC	$138.04	$338.84	$588.84