Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.52 / $4.75 / $4.75	Facility	26	$2.52	$4.75	$4.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.86 / $39.09 / $88.00	Professional		$23.86	$39.09	$88.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.52 / $3.93 / $15.00	Professional	26	$2.52	$3.93	$15.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.67 / $15.92 / $67.53	Professional	52	$9.67	$15.92	$67.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.80 / $33.75 / $45.59	Professional	TC	$16.80	$33.75	$45.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.83 / $13.83 / $13.83	Professional	TC	$13.83	$13.83	$13.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.16 / $15.76 / $29.94	Professional		$2.16	$15.76	$29.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.54 / $40.25 / $57.77	Professional		$26.54	$40.25	$57.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.45 / $4.63 / $6.39	Professional	26	$3.45	$4.63	$6.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $34.82 / $50.84	Professional	TC	$24.23	$34.82	$50.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.33 / $32.34 / $32.89	Professional		$4.33	$32.34	$32.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.19 / $45.50 / $59.02	Professional		$27.19	$45.50	$59.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $3.53 / $4.93 / $6.39	Professional	26	$3.53	$4.93	$6.39
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $35.96 / $48.45	Professional	TC	$24.23	$35.96	$48.45
United Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $51.46 / $132.49	Professional		$29.05	$51.46	$132.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.61 / $5.34 / $7.29	Professional	26	$3.61	$5.34	$7.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.39 / $42.92 / $108.90	Professional	TC	$24.39	$42.92	$108.90