Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.20 / $33.20 / $77.79	Facility	26	$33.20	$33.20	$77.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.76 / $95.84 / $174.25	Professional		$62.76	$95.84	$174.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.20 / $39.78 / $130.08	Professional	26	$33.20	$39.78	$130.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.55 / $52.02 / $83.60	Professional	TC	$29.55	$52.02	$83.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $77.84 / $77.84	Professional		$77.84	$77.84	$77.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.94 / $24.94 / $24.94	Professional	26	$24.94	$24.94	$24.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $58.98 / $119.56	Professional		$31.57	$58.98	$119.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.53 / $117.53 / $158.12	Professional		$67.53	$117.53	$158.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.94 / $50.56 / $72.04	Professional	26	$32.94	$50.56	$72.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.53 / $64.23 / $104.88	Professional	TC	$34.53	$64.23	$104.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $44.66 / $94.60	Professional		$32.34	$44.66	$94.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $74.33 / $130.54 / $186.14	Professional		$74.33	$130.54	$186.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.99 / $51.75 / $68.30	Professional	26	$32.99	$51.75	$68.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.61 / $61.82 / $87.58	Professional	TC	$34.61	$61.82	$87.58
United Facility/Professional Professional Modifier Low / Median / High Price $62.27 / $104.52 / $188.96	Professional		$62.27	$104.52	$188.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.50 / $35.56 / $88.49	Professional	26	$33.50	$35.56	$88.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.61 / $61.31 / $100.00	Professional	TC	$27.61	$61.31	$100.00