Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.60 / $30.60 / $64.50	Facility	26	$30.60	$30.60	$64.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $122.64 / $489.00	Professional		$90.81	$122.64	$489.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $51.60 / $210.00	Professional	26	$36.61	$51.60	$210.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.46 / $69.69 / $128.80	Professional	TC	$51.46	$69.69	$128.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.44 / $60.44 / $60.44	Professional	TC	$60.44	$60.44	$60.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $75.65 / $135.61	Professional		$28.79	$75.65	$135.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.29 / $141.25 / $199.93	Professional		$93.29	$141.25	$199.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $53.24 / $73.70	Professional	26	$35.71	$53.24	$73.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.58 / $87.68 / $127.82	Professional	TC	$57.58	$87.68	$127.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $57.14 / $136.82	Professional		$32.34	$57.14	$136.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.01 / $180.81 / $264.19	Professional		$97.01	$180.81	$264.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $56.30 / $73.70	Professional	26	$35.71	$56.30	$73.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $57.58 / $94.22 / $122.62	Professional	TC	$57.58	$94.22	$122.62
United Facility/Professional Professional Modifier Low / Median / High Price $110.72 / $115.50 / $224.50	Professional		$110.72	$115.50	$224.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.13 / $44.61 / $85.21	Professional	26	$42.13	$44.61	$85.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.52 / $74.51 / $141.29	Professional	TC	$68.52	$74.51	$141.29