Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.75 / $168.44 / $168.44	Facility	26	$106.75	$168.44	$168.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.48 / $240.87 / $587.53	Professional		$175.48	$240.87	$587.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.75 / $138.21 / $227.00	Professional	26	$106.75	$138.21	$227.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.73 / $93.82 / $148.97	Professional	TC	$68.73	$93.82	$148.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.92 / $174.92 / $188.09	Professional		$174.92	$174.92	$188.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.30 / $161.50 / $295.70	Professional		$92.30	$161.50	$295.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.10 / $312.91 / $437.79	Professional		$228.10	$312.91	$437.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $141.08 / $187.81 / $270.81	Professional	26	$141.08	$187.81	$270.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.45 / $128.26 / $172.00	Professional	TC	$88.45	$128.26	$172.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $110.29 / $295.02	Professional		$32.34	$110.29	$295.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $228.10 / $334.49 / $502.76	Professional		$228.10	$334.49	$502.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $132.63 / $184.65 / $241.67	Professional	26	$132.63	$184.65	$241.67
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $88.45 / $123.83 / $164.10	Professional	TC	$88.45	$123.83	$164.10
United Facility/Professional Professional Modifier Low / Median / High Price $292.77 / $360.26 / $517.45	Professional		$292.77	$360.26	$517.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $170.71 / $201.93 / $301.00	Professional	26	$170.71	$201.93	$301.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.56 / $147.97 / $216.45	Professional	TC	$120.56	$147.97	$216.45