Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.37 / $160.34 / $183.55	Facility	26	$78.37	$160.34	$183.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.29 / $415.29 / $482.09	Professional		$231.29	$415.29	$482.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.37 / $96.23 / $204.91	Professional	26	$78.37	$96.23	$204.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.93 / $309.93 / $385.85	Professional	TC	$152.93	$309.93	$385.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.76 / $226.68 / $406.37	Professional		$63.76	$226.68	$406.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.43 / $572.72 / $801.97	Professional		$316.43	$572.72	$801.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.31 / $122.51 / $174.07	Professional	26	$76.31	$122.51	$174.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.86 / $436.73 / $627.90	Professional	TC	$229.86	$436.73	$627.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $110.02 / $378.83	Professional		$32.34	$110.02	$378.83
Providence Facility/Professional Professional Modifier Low / Median / High Price $380.74 / $619.91 / $900.88	Professional		$380.74	$619.91	$900.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $80.58 / $125.16 / $161.16	Professional	26	$80.58	$125.16	$161.16
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $229.86 / $418.53 / $627.90	Professional	TC	$229.86	$418.53	$627.90
United Facility/Professional Professional Modifier Low / Median / High Price $306.77 / $451.52 / $870.01	Professional		$306.77	$451.52	$870.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.95 / $83.39 / $209.49	Professional	26	$77.95	$83.39	$209.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $225.17 / $359.66 / $638.58	Professional	TC	$225.17	$359.66	$638.58