Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.63 / $38.40 / $43.98	Facility	26	$20.63	$38.40	$43.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $88.15 / $378.75	Professional		$43.34	$88.15	$378.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $28.70 / $151.00	Professional	26	$23.46	$28.70	$151.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.67 / $35.61 / $444.97	Professional	52	$21.67	$35.61	$444.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.71 / $58.20 / $168.81	Professional	TC	$22.71	$58.20	$168.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.93 / $56.93 / $56.93	Professional		$56.93	$56.93	$56.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $25.82 / $25.82	Professional	26	$25.82	$25.82	$25.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.35 / $39.69 / $79.39	Professional		$19.35	$39.69	$79.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.54 / $101.75 / $144.15	Professional		$56.54	$101.75	$144.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $34.89 / $49.77	Professional	26	$23.25	$34.89	$49.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.62 / $66.65 / $98.52	Professional	TC	$28.62	$66.65	$98.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $39.43 / $86.72	Professional		$32.34	$39.43	$86.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.43 / $110.23 / $160.33	Professional		$65.43	$110.23	$160.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.65 / $37.15 / $49.77	Professional	26	$24.65	$37.15	$49.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.62 / $66.65 / $98.52	Professional	TC	$28.62	$66.65	$98.52
United Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $92.55 / $156.94	Professional		$80.48	$92.55	$156.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.18 / $29.59 / $58.21	Professional	26	$27.18	$29.59	$58.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.89 / $61.98 / $102.94	Professional	TC	$50.89	$61.98	$102.94