Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.75 / $74.75 / $175.26	Facility	26	$74.75	$74.75	$175.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.09 / $409.01 / $477.42	Professional		$228.09	$409.01	$477.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.75 / $89.50 / $140.21	Professional	26	$74.75	$89.50	$140.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.33 / $268.80 / $385.85	Professional	TC	$153.33	$268.80	$385.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.83 / $213.71 / $469.89	Professional		$75.83	$213.71	$469.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.27 / $547.70 / $817.66	Professional		$292.27	$547.70	$817.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.01 / $116.90 / $166.47	Professional	26	$74.01	$116.90	$166.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $416.27 / $651.20	Professional	TC	$210.00	$416.27	$651.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $104.72 / $314.94	Professional		$32.34	$104.72	$314.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $354.26 / $584.87 / $859.86	Professional		$354.26	$584.87	$859.86
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $76.94 / $116.90 / $153.88	Professional	26	$76.94	$116.90	$153.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $413.46 / $651.20	Professional	TC	$210.00	$413.46	$651.20
United Facility/Professional Professional Modifier Low / Median / High Price $278.54 / $444.91 / $773.10	Professional		$278.54	$444.91	$773.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.51 / $91.67 / $203.03	Professional	26	$75.51	$91.67	$203.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.62 / $346.41 / $568.95	Professional	TC	$200.62	$346.41	$568.95