Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.01 / $53.01 / $124.49	Facility	26	$53.01	$53.01	$124.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.96 / $345.01 / $444.84	Professional		$192.96	$345.01	$444.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.01 / $72.30 / $154.51	Professional	26	$53.01	$72.30	$154.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $139.94 / $245.41 / $375.83	Professional	TC	$139.94	$245.41	$375.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.15 / $148.06 / $325.54	Professional		$50.15	$148.06	$325.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.60 / $454.43 / $687.04	Professional		$214.60	$454.43	$687.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.96 / $87.46 / $124.79	Professional	26	$55.96	$87.46	$124.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.29 / $372.65 / $550.88	Professional	TC	$151.29	$372.65	$550.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $73.54 / $279.08	Professional		$32.34	$73.54	$279.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $280.87 / $500.32 / $642.88	Professional		$280.87	$500.32	$642.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.89 / $89.76 / $120.89	Professional	26	$56.89	$89.76	$120.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $160.88 / $372.65 / $566.37	Professional	TC	$160.88	$372.65	$566.37
United Facility/Professional Professional Modifier Low / Median / High Price $213.81 / $375.55 / $693.77	Professional		$213.81	$375.55	$693.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.91 / $64.59 / $155.74	Professional	26	$54.91	$64.59	$155.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.90 / $313.00 / $599.03	Professional	TC	$158.90	$313.00	$599.03