Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.19 / $53.19 / $125.33	Facility	26	$53.19	$53.19	$125.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.05 / $322.77 / $342.37	Professional		$180.05	$322.77	$342.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $72.30 / $100.26	Professional	26	$53.19	$72.30	$100.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.87 / $222.53 / $287.81	Professional	TC	$126.87	$222.53	$287.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.73 / $139.15 / $305.94	Professional		$53.73	$139.15	$305.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.50 / $415.56 / $628.05	Professional		$201.50	$415.56	$628.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $81.09 / $116.05	Professional	26	$52.46	$81.09	$116.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.19 / $342.31 / $506.02	Professional	TC	$138.19	$342.31	$506.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $73.54 / $250.30	Professional		$32.34	$73.54	$250.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $263.77 / $450.06 / $603.67	Professional		$263.77	$450.06	$603.67
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $55.02 / $83.71 / $110.04	Professional	26	$55.02	$83.71	$110.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $144.69 / $342.31 / $512.01	Professional	TC	$144.69	$342.31	$512.01
United Facility/Professional Professional Modifier Low / Median / High Price $197.86 / $354.08 / $645.86	Professional		$197.86	$354.08	$645.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.86 / $55.18 / $141.41	Professional	26	$51.86	$55.18	$141.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.94 / $298.89 / $521.99	Professional	TC	$142.94	$298.89	$521.99