Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $85.11 / $85.11	Facility	26	$81.28	$85.11	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $457.09	Professional		$173.78	$257.04	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $63.10 / $117.49	Professional	26	$51.29	$63.10	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $190.55 / $323.59	Professional	TC	$123.03	$190.55	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $138.04 / $309.03	Professional		$54.95	$138.04	$309.03
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 $50.12 / $77.62 / $114.82	Professional	26	$50.12	$77.62	$114.82
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 / $251.19	Professional		$32.36	$33.11	$251.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $436.52 / $630.96	Professional		$257.04	$436.52	$630.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $114.82	Professional	26	$56.23	$81.28	$114.82
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 / $354.81 / $588.84	Professional		$199.53	$354.81	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $54.95 / $123.03	Professional	26	$51.29	$54.95	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $302.00 / $478.63	Professional	TC	$144.54	$302.00	$478.63