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 / $382.50	Facility	26	$60.32	$156.15	$382.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.32 / $475.00 / $712.50	Professional		$195.32	$475.00	$712.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.86 / $140.00 / $264.06	Professional	26	$64.86	$140.00	$264.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.66 / $350.00 / $350.00	Professional	52	$97.66	$350.00	$350.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.00 / $335.00 / $631.87	Professional	TC	$135.00	$335.00	$631.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.16 / $201.16 / $201.16	Professional		$201.16	$201.16	$201.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $84.34 / $90.41 / $131.21	Professional	26	$84.34	$90.41	$131.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.06 / $142.90 / $279.67	Professional		$46.06	$142.90	$279.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.16 / $546.44 / $807.79	Professional		$204.16	$546.44	$807.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.28 / $87.71 / $125.61	Professional	26	$56.28	$87.71	$125.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.38 / $468.86 / $693.09	Professional	TC	$140.38	$468.86	$693.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $78.81 / $242.57	Professional		$32.34	$78.81	$242.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $272.83 / $499.53 / $736.51	Professional		$272.83	$499.53	$736.51
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.91 / $89.73 / $117.81	Professional	26	$58.91	$89.73	$117.81
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $140.38 / $468.86 / $678.00	Professional	TC	$140.38	$468.86	$678.00
United Facility/Professional Professional Modifier Low / Median / High Price $197.56 / $423.95 / $735.49	Professional		$197.56	$423.95	$735.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.69 / $63.58 / $154.85	Professional	26	$56.69	$63.58	$154.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $338.79 / $548.66	Professional	TC	$138.66	$338.79	$548.66