Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $162.18	Facility	26	$57.54	$57.54	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $275.42 / $575.44	Professional		$204.17	$275.42	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.90 / $83.18	Professional	26	$33.88	$38.90	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $234.42 / $323.59	Professional	TC	$186.21	$234.42	$323.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $169.82 / $302.00	Professional		$27.54	$169.82	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $316.23 / $426.58	Professional		$245.47	$316.23	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $47.86 / $69.18	Professional	26	$37.15	$47.86	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $269.15 / $363.08	Professional	TC	$204.17	$269.15	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $338.84	Professional		$32.36	$33.11	$338.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $380.19 / $602.56	Professional		$245.47	$380.19	$602.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $52.48 / $70.79	Professional	26	$37.15	$52.48	$70.79
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $288.40 / $371.54	Professional	TC	$194.98	$288.40	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $537.03	Professional		$269.15	$389.05	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $58.88 / $77.62	Professional	26	$39.81	$58.88	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $338.84 / $457.09	Professional	TC	$234.42	$338.84	$457.09