Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.72 / $58.09 / $58.09	Facility	26	$36.72	$58.09	$58.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $114.09 / $411.00	Professional		$84.00	$114.09	$411.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $50.34 / $149.33	Professional	26	$36.72	$50.34	$149.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.17 / $44.72 / $75.76	Professional	TC	$40.17	$44.72	$75.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $83.65 / $83.65	Professional		$79.98	$83.65	$83.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.93 / $49.93 / $49.93	Professional	26	$49.93	$49.93	$49.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.55 / $66.31 / $116.02	Professional		$31.55	$66.31	$116.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.17 / $130.96 / $183.00	Professional		$97.17	$130.96	$183.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.26 / $67.41 / $88.23	Professional	26	$48.26	$67.41	$88.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.70 / $58.91 / $103.89	Professional	TC	$43.70	$58.91	$103.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $63.14 / $132.72	Professional		$32.34	$63.14	$132.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.17 / $132.59 / $227.42	Professional		$97.17	$132.59	$227.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $48.26 / $65.09 / $88.23	Professional	26	$48.26	$65.09	$88.23
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $42.55 / $57.52 / $92.09	Professional	TC	$42.55	$57.52	$92.09
United Facility/Professional Professional Modifier Low / Median / High Price $115.65 / $141.35 / $200.76	Professional		$115.65	$141.35	$200.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.33 / $75.98 / $95.91	Professional	26	$56.33	$75.98	$95.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.46 / $70.56 / $111.41	Professional	TC	$55.46	$70.56	$111.41