Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.18 / $42.98 / $49.20	Facility	26	$23.18	$42.98	$49.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $98.86 / $411.00	Professional		$79.00	$98.86	$411.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $39.36 / $129.00	Professional	26	$27.64	$39.36	$129.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.59 / $59.50 / $286.00	Professional	TC	$40.59	$59.50	$286.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.39 / $24.83 / $43.54	Professional	26	$23.39	$24.83	$43.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.07 / $35.07 / $35.07	Professional	TC	$35.07	$35.07	$35.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $55.87 / $111.75	Professional		$21.94	$55.87	$111.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.48 / $107.39 / $152.96	Professional		$70.48	$107.39	$152.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.87 / $40.47 / $56.23	Professional	26	$26.87	$40.47	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.14 / $69.04 / $96.88	Professional	TC	$44.14	$69.04	$96.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $47.61 / $117.05	Professional		$32.34	$47.61	$117.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $73.34 / $139.75 / $195.93	Professional		$73.34	$139.75	$195.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.85 / $43.23 / $56.23	Professional	26	$27.85	$43.23	$56.23
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $44.14 / $69.04 / $96.88	Professional	TC	$44.14	$69.04	$96.88
United Facility/Professional Professional Modifier Low / Median / High Price $85.53 / $100.06 / $168.27	Professional		$85.53	$100.06	$168.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.60 / $33.77 / $71.89	Professional	26	$31.60	$33.77	$71.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.33 / $61.95 / $105.85	Professional	TC	$52.33	$61.95	$105.85