Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $87.10 / $109.65	Facility	26	$77.62	$87.10	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $794.33	Professional		$102.33	$154.88	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $134.90 / $933.25	Professional	26	$57.54	$134.90	$933.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $72.44 / $380.19	Professional	TC	$51.29	$72.44	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $58.88 / $58.88	Professional	26	$57.54	$58.88	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $87.10 / $151.36	Professional		$42.66	$87.10	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $338.84	Professional		$169.82	$223.87	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $87.10 / $138.04	Professional	26	$70.79	$87.10	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $125.89 / $199.53	Professional	TC	$89.13	$125.89	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $77.62	Professional		$32.36	$33.11	$77.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $213.80 / $275.42	Professional		$117.49	$213.80	$275.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $87.10 / $114.82	Professional	26	$67.61	$87.10	$114.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $117.49 / $165.96	Professional	TC	$69.18	$117.49	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $199.53 / $251.19	Professional		$162.18	$199.53	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $77.62 / $123.03	Professional	26	$74.13	$77.62	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $120.23 / $141.25	Professional	TC	$85.11	$120.23	$141.25