Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.01 / $49.88 / $57.10	Facility	26	$27.01	$49.88	$57.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.95 / $112.99 / $461.00	Professional		$88.95	$112.99	$461.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.62 / $45.68 / $129.60	Professional	26	$30.62	$45.68	$129.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.94 / $67.31 / $161.16	Professional	TC	$45.94	$67.31	$161.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.92 / $65.92 / $65.92	Professional		$65.92	$65.92	$65.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.58 / $28.58 / $28.58	Professional	26	$28.58	$28.58	$28.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.51 / $63.90 / $118.40	Professional		$25.51	$63.90	$118.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $122.08 / $172.67	Professional		$79.95	$122.08	$172.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.45 / $47.13 / $65.25	Professional	26	$31.45	$47.13	$65.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.72 / $78.11 / $107.82	Professional	TC	$49.72	$78.11	$107.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $54.80 / $127.49	Professional		$32.34	$54.80	$127.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $83.13 / $157.75 / $224.04	Professional		$83.13	$157.75	$224.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.00 / $49.79 / $65.25	Professional	26	$32.00	$49.79	$65.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $49.72 / $78.11 / $107.82	Professional	TC	$49.72	$78.11	$107.82
United Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $105.18 / $200.64	Professional		$97.44	$105.18	$200.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.04 / $38.77 / $87.90	Professional	26	$37.04	$38.77	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.19 / $69.95 / $150.29	Professional	TC	$59.19	$69.95	$150.29