Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.71 / $72.19 / $72.19	Facility	26	$44.71	$72.19	$72.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.78 / $297.86 / $1,182.00	Professional		$235.78	$297.86	$1,182.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $94.20 / $372.50	Professional	26	$55.84	$94.20	$372.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $194.53 / $388.49	Professional	TC	$162.34	$194.53	$388.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $250.00 / $250.00	Professional		$250.00	$250.00	$250.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.34 / $76.34 / $1,453.20	Professional	26	$76.34	$76.34	$1,453.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $180.16 / $314.44	Professional		$39.29	$180.16	$314.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.12 / $436.69 / $618.64	Professional		$291.12	$436.69	$618.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.42 / $103.11 / $152.41	Professional	26	$64.42	$103.11	$152.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $219.40 / $329.09 / $466.22	Professional	TC	$219.40	$329.09	$466.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $84.30 / $381.19	Professional		$32.34	$84.30	$381.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $298.91 / $514.71 / $679.82	Professional		$298.91	$514.71	$679.82
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $64.61 / $103.11 / $152.41	Professional	26	$64.61	$103.11	$152.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $232.78 / $329.09 / $466.22	Professional	TC	$232.78	$329.09	$466.22
United Facility/Professional Professional Modifier Low / Median / High Price $313.20 / $514.01 / $671.41	Professional		$313.20	$514.01	$671.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.28 / $116.51 / $160.21	Professional	26	$71.28	$116.51	$160.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $272.79 / $387.59 / $532.58	Professional	TC	$272.79	$387.59	$532.58