Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.22 / $64.72 / $74.09	Facility	26	$35.22	$64.72	$74.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.27 / $142.60 / $519.00	Professional		$103.27	$142.60	$519.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $59.27 / $190.00	Professional	26	$42.60	$59.27	$190.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.70 / $83.33 / $131.31	Professional	TC	$52.70	$83.33	$131.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.76 / $83.76 / $83.76	Professional		$83.76	$83.76	$83.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.31 / $66.31 / $66.31	Professional	26	$66.31	$66.31	$66.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.90 / $48.90 / $48.90	Professional	TC	$48.90	$48.90	$48.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $80.98 / $162.57	Professional		$33.47	$80.98	$162.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.27 / $157.26 / $216.46	Professional		$101.27	$157.26	$216.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.39 / $61.15 / $84.67	Professional	26	$41.39	$61.15	$84.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.47 / $96.70 / $132.90	Professional	TC	$61.47	$96.70	$132.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.39 / $172.58	Professional		$32.34	$72.39	$172.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $105.88 / $197.76 / $282.66	Professional		$105.88	$197.76	$282.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $41.80 / $65.76 / $84.67	Professional	26	$41.80	$65.76	$84.67
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $61.47 / $96.70 / $131.88	Professional	TC	$61.47	$96.70	$131.88
United Facility/Professional Professional Modifier Low / Median / High Price $124.51 / $131.72 / $244.95	Professional		$124.51	$131.72	$244.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.93 / $51.28 / $100.12	Professional	26	$48.93	$51.28	$100.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.62 / $83.39 / $144.83	Professional	TC	$73.62	$83.39	$144.83