Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.24 / $34.24 / $77.59	Facility	26	$34.24	$34.24	$77.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.13 / $176.86 / $435.00	Professional		$70.13	$176.86	$435.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $59.28 / $226.81	Professional	26	$42.14	$59.28	$226.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.07 / $46.61 / $314.14	Professional	52	$35.07	$46.61	$314.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.89 / $117.78 / $158.51	Professional	TC	$35.89	$117.78	$158.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.38 / $40.38 / $40.38	Professional	26	$40.38	$40.38	$40.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.72 / $77.95 / $152.16	Professional		$40.72	$77.95	$152.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.24 / $210.00 / $329.85	Professional		$133.24	$210.00	$329.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.03 / $80.54 / $115.83	Professional	26	$60.03	$80.54	$115.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.08 / $135.65 / $193.00	Professional	TC	$70.08	$135.65	$193.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $62.12 / $157.97	Professional		$32.34	$62.12	$157.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $122.34 / $218.75 / $297.51	Professional		$122.34	$218.75	$297.51
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $49.57 / $79.25 / $115.83	Professional	26	$49.57	$79.25	$115.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $70.08 / $141.31 / $214.02	Professional	TC	$70.08	$141.31	$214.02
United Facility/Professional Professional Modifier Low / Median / High Price $158.41 / $264.10 / $417.61	Professional		$158.41	$264.10	$417.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.72 / $100.80 / $141.41	Professional	26	$62.72	$100.80	$141.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.97 / $165.12 / $237.36	Professional	TC	$96.97	$165.12	$237.36