Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.90 / $95.73 / $119.68	Facility	26	$50.90	$95.73	$119.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.48 / $317.76 / $424.51	Professional		$177.48	$317.76	$424.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.90 / $62.45 / $95.74	Professional	26	$50.90	$62.45	$95.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.58 / $222.02 / $365.88	Professional	TC	$126.58	$222.02	$365.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.82 / $137.19 / $320.20	Professional		$53.82	$137.19	$320.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.54 / $423.94 / $648.09	Professional		$199.54	$423.94	$648.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $78.48 / $111.59	Professional	26	$50.12	$78.48	$111.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.18 / $354.52 / $536.50	Professional	TC	$139.18	$354.52	$536.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $70.19 / $253.95	Professional		$32.34	$70.19	$253.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $261.30 / $468.53 / $594.86	Professional		$261.30	$468.53	$594.86
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $79.95 / $105.08	Professional	26	$52.54	$79.95	$105.08
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $150.28 / $354.52 / $536.50	Professional	TC	$150.28	$354.52	$536.50
United Facility/Professional Professional Modifier Low / Median / High Price $201.24 / $353.17 / $694.80	Professional		$201.24	$353.17	$694.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.04 / $62.07 / $149.63	Professional	26	$50.04	$62.07	$149.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.47 / $297.94 / $448.99	Professional	TC	$148.47	$297.94	$448.99