Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.63 / $40.17 / $127.50	Facility	26	$21.63	$40.17	$127.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.14 / $56.26 / $214.17	Professional		$50.14	$56.26	$214.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.57 / $30.44 / $88.04	Professional	26	$26.57	$30.44	$88.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $56.80 / $220.80 / $299.00	Professional	52	$56.80	$220.80	$299.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $25.32 / $67.98	Professional	TC	$18.73	$25.32	$67.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.23 / $25.04 / $27.03	Professional	26	$21.23	$25.04	$27.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.11 / $36.31 / $69.55	Professional		$20.11	$36.31	$69.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.14 / $67.26 / $97.29	Professional		$45.14	$67.26	$97.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $37.10 / $54.22	Professional	26	$24.73	$37.10	$54.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.38 / $30.16 / $43.06	Professional	TC	$20.38	$30.16	$43.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.50 / $32.34 / $62.60	Professional		$27.50	$32.34	$62.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $50.51 / $84.20 / $121.44	Professional		$50.51	$84.20	$121.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.76 / $37.96 / $52.56	Professional	26	$24.76	$37.96	$52.56
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.38 / $30.78 / $39.44	Professional	TC	$20.38	$30.78	$39.44
United Facility/Professional Professional Modifier Low / Median / High Price $58.76 / $65.45 / $124.04	Professional		$58.76	$65.45	$124.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.77 / $35.44 / $67.15	Professional	26	$31.77	$35.44	$67.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.95 / $28.55 / $54.73	Professional	TC	$26.95	$28.55	$54.73