Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $169.82 / $186.21	Facility	26	$141.25	$169.82	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $489.78 / $1,122.02	Professional		$309.03	$489.78	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $134.90 / $407.38	Professional	26	$85.11	$134.90	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $346.74 / $676.08	Professional	TC	$218.78	$346.74	$676.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $269.15 / $467.74	Professional		$74.13	$269.15	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $660.69 / $954.99	Professional		$363.08	$660.69	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $134.90 / $199.53	Professional	26	$83.18	$134.90	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $512.86 / $741.31	Professional	TC	$257.04	$512.86	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $446.68	Professional		$32.36	$33.11	$446.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $758.58 / $1,071.52	Professional		$426.58	$758.58	$1,071.52
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $138.04 / $199.53	Professional	26	$95.50	$138.04	$199.53
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $537.03 / $741.31	Professional	TC	$323.59	$537.03	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $977.24	Professional		$346.74	$501.19	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $100.00 / $218.78	Professional	26	$89.13	$100.00	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $407.38 / $707.95	Professional	TC	$257.04	$407.38	$707.95