Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $317.89 / $2,145.78 / $7,838.38	Facility		$317.89	$2,145.78	$7,838.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.03 / $42.03 / $42.03	Facility	26	$42.03	$42.03	$42.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $202.52 / $546.00	Professional		$152.68	$202.52	$546.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.58 / $43.81 / $80.48	Professional	26	$38.58	$43.81	$80.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $119.75 / $205.35	Professional	TC	$98.17	$119.75	$205.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.70 / $707.02 / $1,184.45	Facility		$294.70	$707.02	$1,184.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $100.55 / $268.31	Professional		$38.34	$100.55	$268.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.18 / $202.35 / $336.94	Professional		$149.18	$202.35	$336.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.75 / $63.24 / $75.73	Professional	26	$47.75	$63.24	$75.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.43 / $143.03 / $265.67	Professional	TC	$101.43	$143.03	$265.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $60.86 / $257.52	Professional		$32.34	$60.86	$257.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $149.18 / $291.92 / $395.23	Facility		$149.18	$291.92	$395.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $149.18 / $221.55 / $336.94	Professional		$149.18	$221.55	$336.94
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.75 / $62.28 / $75.73	Professional	26	$47.75	$62.28	$75.73
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $101.43 / $145.81 / $265.67	Professional	TC	$101.43	$145.81	$265.67
United Facility/Professional Facility Modifier Low / Median / High Price $775.00 / $1,327.00 / $1,327.00	Facility		$775.00	$1,327.00	$1,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.66 / $232.65 / $343.61	Professional		$163.66	$232.65	$343.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.48 / $69.67 / $90.86	Professional	26	$55.48	$69.67	$90.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.68 / $172.50 / $244.95	Professional	TC	$114.68	$172.50	$244.95