Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.70 / $69.70 / $69.70	Facility	26	$69.70	$69.70	$69.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.43 / $388.43 / $809.54	Professional		$345.43	$388.43	$809.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.70 / $81.96 / $147.99	Professional	26	$69.70	$81.96	$147.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $275.73 / $302.33 / $677.81	Professional	TC	$275.73	$302.33	$677.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.33 / $266.33 / $409.11	Professional		$266.33	$266.33	$409.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.48 / $72.48 / $72.48	Professional	26	$72.48	$72.48	$72.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.09 / $245.90 / $478.80	Professional		$79.09	$245.90	$478.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.00 / $526.61 / $842.22	Professional		$365.00	$526.61	$842.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.10 / $123.39 / $177.26	Professional	26	$92.10	$123.39	$177.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $254.65 / $394.71 / $664.31	Professional	TC	$254.65	$394.71	$664.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $120.66 / $602.07	Professional		$32.34	$120.66	$602.07
Providence Facility/Professional Professional Modifier Low / Median / High Price $390.71 / $577.58 / $951.69	Professional		$390.71	$577.58	$951.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $92.10 / $122.66 / $161.58	Professional	26	$92.10	$122.66	$161.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $254.65 / $394.71 / $594.60	Professional	TC	$254.65	$394.71	$594.60
United Facility/Professional Professional Modifier Low / Median / High Price $374.50 / $621.40 / $1,004.84	Professional		$374.50	$621.40	$1,004.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.66 / $139.43 / $201.69	Professional	26	$106.66	$139.43	$201.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.13 / $452.99 / $733.85	Professional	TC	$264.13	$452.99	$733.85