Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $97.72 / $104.71	Facility	26	$81.28	$97.72	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $724.44	Professional		$173.78	$275.42	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $234.42	Professional	26	$51.29	$77.62	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $190.55 / $501.19	Professional	TC	$123.03	$190.55	$501.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $138.04 / $251.19	Professional		$42.66	$138.04	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $416.87 / $630.96	Professional		$190.55	$416.87	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $83.18 / $125.89	Professional	26	$53.70	$83.18	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $338.84 / $501.19	Professional	TC	$134.90	$338.84	$501.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $257.04	Professional		$32.36	$33.11	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $416.87 / $616.60	Professional		$257.04	$416.87	$616.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $125.89	Professional	26	$54.95	$85.11	$125.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $338.84 / $501.19	Professional	TC	$162.18	$338.84	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $363.08 / $602.56	Professional		$199.53	$363.08	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $60.26 / $134.90	Professional	26	$56.23	$60.26	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $302.00 / $478.63	Professional	TC	$141.25	$302.00	$478.63