Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.95 / $12.95 / $27.04	Facility	26	$12.95	$12.95	$27.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.46 / $65.68 / $123.90	Professional		$58.46	$65.68	$123.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.95 / $16.30 / $26.57	Professional	26	$12.95	$16.30	$26.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.51 / $49.39 / $76.89	Professional	TC	$45.51	$49.39	$76.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.26 / $53.95 / $118.62	Professional		$14.26	$53.95	$118.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.05 / $86.62 / $115.58	Professional		$66.05	$86.62	$115.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.01 / $21.83 / $30.90	Professional	26	$15.01	$21.83	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.09 / $63.12 / $86.01	Professional	TC	$50.09	$63.12	$86.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.94 / $32.34 / $93.33	Professional		$20.94	$32.34	$93.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $69.80 / $109.77 / $176.44	Professional		$69.80	$109.77	$176.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.05 / $22.32 / $31.89	Professional	26	$15.05	$22.32	$31.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $50.09 / $63.12 / $86.01	Professional	TC	$50.09	$63.12	$86.01
United Facility/Professional Professional Modifier Low / Median / High Price $66.50 / $79.76 / $155.53	Professional		$66.50	$79.76	$155.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $18.95 / $39.50	Professional	26	$17.02	$18.95	$39.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.15 / $60.99 / $126.01	Professional	TC	$50.15	$60.99	$126.01