Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $34.67 / $34.67	Facility	26	$21.88	$34.67	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $177.83	Professional		$39.81	$52.48	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.84 / $69.18	Professional	26	$21.88	$28.84	$69.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.90 / $38.90 / $38.90	Professional	52	$38.90	$38.90	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $67.61	Professional	TC	$16.98	$22.91	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $33.88	Professional	26	$33.88	$33.88	$33.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $35.48 / $72.44	Professional		$20.42	$35.48	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Professional	26	$25.12	$25.12	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.13 / $14.13	Professional	TC	$14.13	$14.13	$14.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $52.48	Professional		$31.62	$33.11	$52.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $95.50 / $141.25	Professional		$37.15	$95.50	$141.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Professional	26	$25.70	$25.70	$25.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $11.75 / $11.75	Professional	TC	$11.75	$11.75	$11.75
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $66.07 / $109.65	Professional		$58.88	$66.07	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $33.88 / $60.26	Professional	26	$32.36	$33.88	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.84 / $48.98	Professional	TC	$26.92	$28.84	$48.98