Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.60 / $197.60 / $197.60	Facility		$197.60	$197.60	$197.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $88.26 / $171.60	Professional		$79.40	$88.26	$171.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.96 / $55.28 / $104.28	Professional	26	$50.96	$55.28	$104.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.42 / $32.97 / $76.47	Professional	TC	$28.42	$32.97	$76.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $121.63 / $121.63 / $121.63	Professional	26	$121.63	$121.63	$121.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.25 / $88.81 / $156.56	Professional		$54.25	$88.81	$156.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.96 / $102.08 / $169.11	Professional		$81.96	$102.08	$169.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.63 / $73.11 / $109.92	Professional	26	$50.63	$73.11	$109.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.34 / $37.69 / $51.90	Professional	TC	$31.34	$37.69	$51.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $70.98 / $139.45	Professional		$32.34	$70.98	$139.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.28 / $92.71 / $155.94	Facility		$84.28	$92.71	$155.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.27 / $128.72 / $269.64	Professional		$97.27	$128.72	$269.64
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $59.15 / $73.11 / $96.38	Professional	26	$59.15	$73.11	$96.38
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $34.82 / $37.85 / $51.90	Professional	TC	$34.82	$37.85	$51.90
United Facility/Professional Professional Modifier Low / Median / High Price $54.84 / $60.20 / $160.53	Professional		$54.84	$60.20	$160.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.68 / $39.19 / $104.51	Professional	26	$35.68	$39.19	$104.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $21.01 / $56.02	Professional	TC	$17.48	$21.01	$56.02