Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.97 / $24.97 / $52.90	Facility	26	$24.97	$24.97	$52.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.36 / $111.78 / $400.00	Professional		$84.36	$111.78	$400.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.97 / $34.47 / $78.41	Professional	26	$24.97	$34.47	$78.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.39 / $74.53 / $93.88	Professional	TC	$59.39	$74.53	$93.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $31.53 / $31.53	Professional	26	$31.53	$31.53	$31.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.60 / $75.20 / $165.37	Professional		$29.60	$75.20	$165.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.79 / $139.81 / $186.84	Professional		$93.79	$139.81	$186.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $43.19 / $60.46	Professional	26	$28.84	$43.19	$60.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.40 / $93.30 / $123.71	Professional	TC	$65.40	$93.30	$123.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $126.97	Professional		$32.34	$32.34	$126.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $99.86 / $163.83 / $253.58	Professional		$99.86	$163.83	$253.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.89 / $44.10 / $60.46	Professional	26	$28.89	$44.10	$60.46
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $65.40 / $93.30 / $123.71	Professional	TC	$65.40	$93.30	$123.71
United Facility/Professional Professional Modifier Low / Median / High Price $104.11 / $110.43 / $241.74	Professional		$104.11	$110.43	$241.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $37.61 / $78.20	Professional	26	$33.70	$37.61	$78.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $78.45 / $163.54	Professional	TC	$72.44	$78.45	$163.54