Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.02 / $49.92 / $156.40	Facility	26	$27.02	$49.92	$156.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.73 / $148.90 / $553.86	Professional		$124.73	$148.90	$553.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $40.43 / $150.00	Professional	26	$32.71	$40.43	$150.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.02 / $564.00 / $762.00	Professional	52	$40.02	$564.00	$762.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.51 / $99.73 / $260.25	Professional	TC	$76.51	$99.73	$260.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.32 / $128.32 / $128.32	Professional		$128.32	$128.32	$128.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.97 / $31.82 / $34.35	Professional	26	$26.97	$31.82	$34.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.82 / $87.60 / $161.10	Professional		$25.82	$87.60	$161.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.95 / $163.05 / $234.42	Professional		$109.95	$163.05	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.50 / $45.89 / $67.09	Professional	26	$31.50	$45.89	$67.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.42 / $117.17 / $167.32	Professional	TC	$78.42	$117.17	$167.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $44.62 / $150.50	Professional		$32.34	$44.62	$150.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.43 / $205.54 / $294.06	Professional		$125.43	$205.54	$294.06
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $47.17 / $65.31	Professional	26	$31.53	$47.17	$65.31
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $78.42 / $118.46 / $167.32	Professional	TC	$78.42	$118.46	$167.32
United Facility/Professional Professional Modifier Low / Median / High Price $143.88 / $160.50 / $304.14	Professional		$143.88	$160.50	$304.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.29 / $43.77 / $82.94	Professional	26	$39.29	$43.77	$82.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.64 / $116.73 / $221.21	Professional	TC	$104.64	$116.73	$221.21