Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.00 / $48.06 / $739.80	Facility	26	$26.00	$48.06	$739.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.51 / $117.69 / $482.00	Professional		$79.51	$117.69	$482.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.08 / $37.54 / $119.27	Professional	26	$28.08	$37.54	$119.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $633.00 / $661.50 / $723.00	Professional	50	$633.00	$661.50	$723.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.21 / $76.73 / $126.90	Professional	TC	$51.21	$76.73	$126.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.56 / $99.56 / $99.56	Professional		$99.56	$99.56	$99.56
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $109.56 / $109.56 / $149.34	Professional	50	$109.56	$109.56	$149.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $70.59 / $129.84	Professional		$24.86	$70.59	$129.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.14 / $129.99 / $178.59	Professional		$88.14	$129.99	$178.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.46 / $45.42 / $62.89	Professional	26	$30.46	$45.42	$62.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.39 / $86.40 / $115.70	Professional	TC	$57.39	$86.40	$115.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $49.78 / $129.27	Professional		$32.34	$49.78	$129.27
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.47 / $157.82 / $239.78	Professional		$92.47	$157.82	$239.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $48.87 / $62.89	Professional	26	$31.12	$48.87	$62.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $57.73 / $90.59 / $115.70	Professional	TC	$57.73	$90.59	$115.70
United Facility/Professional Professional Modifier Low / Median / High Price $104.11 / $127.58 / $214.42	Professional		$104.11	$127.58	$214.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.68 / $42.75 / $82.94	Professional	26	$35.68	$42.75	$82.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.42 / $83.80 / $152.77	Professional	TC	$68.42	$83.80	$152.77