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 $168.65 / $302.14 / $430.29	Professional		$168.65	$302.14	$430.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.01 / $72.30 / $99.59	Professional	26	$53.01	$72.30	$99.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $115.64 / $202.54 / $359.11	Professional	TC	$115.64	$202.54	$359.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $129.79 / $232.67	Professional		$56.39	$129.79	$232.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.84 / $423.29 / $625.73	Professional		$181.84	$423.29	$625.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.82 / $87.46 / $125.46	Professional	26	$55.82	$87.46	$125.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.49 / $343.05 / $507.12	Professional	TC	$122.49	$343.05	$507.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $73.54 / $219.62	Professional		$32.34	$73.54	$219.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $247.10 / $423.29 / $570.52	Professional		$247.10	$423.29	$570.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $55.82 / $88.02 / $118.61	Professional	26	$55.82	$88.02	$118.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $122.49 / $343.05 / $519.77	Professional	TC	$122.49	$343.05	$519.77
United Facility/Professional Professional Modifier Low / Median / High Price $175.77 / $340.80 / $519.29	Professional		$175.77	$340.80	$519.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $61.31 / $156.61	Professional	26	$55.22	$61.31	$156.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.55 / $285.38 / $397.45	Professional	TC	$120.55	$285.38	$397.45