Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.62 / $148.77 / $855.95	Facility	26	$72.62	$148.77	$855.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $187.10 / $227.65 / $505.21	Professional		$187.10	$227.65	$505.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.62 / $86.94 / $311.73	Professional	26	$72.62	$86.94	$311.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.24 / $141.93 / $305.73	Professional	TC	$93.24	$141.93	$305.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.63 / $182.63 / $182.63	Professional		$182.63	$182.63	$182.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.15 / $72.17 / $524.29	Professional	26	$66.15	$72.17	$524.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $130.09 / $233.21	Professional		$58.88	$130.09	$233.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.79 / $271.04 / $407.37	Professional		$166.79	$271.04	$407.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.92 / $108.70 / $156.41	Professional	26	$71.92	$108.70	$156.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.90 / $162.34 / $250.95	Professional	TC	$99.90	$162.34	$250.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $101.17 / $221.27	Professional		$32.34	$101.17	$221.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $208.49 / $333.59 / $439.18	Professional		$208.49	$333.59	$439.18
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $74.76 / $115.17 / $149.53	Professional	26	$74.76	$115.17	$149.53
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $99.90 / $160.66 / $250.95	Professional	TC	$99.90	$160.66	$250.95
United Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $205.17 / $484.11	Professional		$172.70	$205.17	$484.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.91 / $80.20 / $194.07	Professional	26	$71.91	$80.20	$194.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.93 / $124.96 / $294.86	Professional	TC	$96.93	$124.96	$294.86