Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Facility	26	$158.49	$158.49	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $562.34	Professional		$158.49	$204.17	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $112.20 / $257.04	Professional	26	$91.20	$112.20	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $79.43 / $165.96	Professional	TC	$64.57	$79.43	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $165.96 / $177.83	Professional		$154.88	$165.96	$177.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $263.03	Professional		$74.13	$134.90	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $363.08	Professional		$194.98	$275.42	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $158.49 / $218.78	Professional	26	$114.82	$158.49	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $114.82 / $151.36	Professional	TC	$79.43	$114.82	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $223.87	Professional		$32.36	$33.11	$223.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $257.04 / $331.13	Professional		$190.55	$257.04	$331.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $144.54 / $194.98	Professional	26	$112.20	$144.54	$194.98
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $107.15 / $141.25	Professional	TC	$75.86	$107.15	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $288.40 / $436.52	Professional		$213.80	$288.40	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $162.18 / $251.19	Professional	26	$123.03	$162.18	$251.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $125.89 / $190.55	Professional	TC	$87.10	$125.89	$190.55