Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.45 / $140.25 / $140.25	Facility		$68.45	$140.25	$140.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.42 / $39.42 / $39.42	Facility	26	$39.42	$39.42	$39.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.01 / $107.04 / $251.65	Professional		$38.01	$107.04	$251.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $74.81 / $86.89	Professional	26	$34.61	$74.81	$86.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.84 / $85.51 / $157.97	Professional	TC	$26.84	$85.51	$157.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.79 / $406.24 / $661.97	Facility		$110.79	$406.24	$661.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.29 / $75.75 / $173.46	Professional		$44.29	$75.75	$173.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $234.00 / $336.96	Professional		$92.00	$234.00	$336.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.79 / $93.41 / $144.62	Professional	26	$53.79	$93.41	$144.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.22 / $138.43 / $204.63	Professional	TC	$38.22	$138.43	$204.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $40.32 / $181.58	Professional		$32.34	$40.32	$181.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.28 / $227.94 / $304.89	Facility		$60.28	$227.94	$304.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.23 / $198.21 / $331.29	Professional		$86.23	$198.21	$331.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $53.79 / $93.41 / $132.33	Professional	26	$53.79	$93.41	$132.33
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $38.22 / $144.44 / $204.63	Professional	TC	$38.22	$144.44	$204.63
United Facility/Professional Facility Modifier Low / Median / High Price $230.00 / $1,158.00 / $1,401.00	Facility		$230.00	$1,158.00	$1,401.00
United Facility/Professional Professional Modifier Low / Median / High Price $94.08 / $267.89 / $451.88	Professional		$94.08	$267.89	$451.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.90 / $108.78 / $143.99	Professional	26	$53.90	$108.78	$143.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.18 / $163.56 / $256.32	Professional	TC	$40.18	$163.56	$256.32