Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.34 / $75.34 / $176.60	Facility	26	$75.34	$75.34	$176.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.68 / $410.09 / $482.32	Professional		$228.68	$410.09	$482.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.34 / $91.27 / $204.38	Professional	26	$75.34	$91.27	$204.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.33 / $310.24 / $380.79	Professional	TC	$153.33	$310.24	$380.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.48 / $214.63 / $471.90	Professional		$77.48	$214.63	$471.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.52 / $556.41 / $868.93	Professional		$293.52	$556.41	$868.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.42 / $120.43 / $174.13	Professional	26	$75.42	$120.43	$174.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $443.30 / $694.80	Professional	TC	$210.00	$443.30	$694.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $105.90 / $359.43	Professional		$32.34	$105.90	$359.43
Providence Facility/Professional Professional Modifier Low / Median / High Price $370.95 / $602.79 / $860.76	Professional		$370.95	$602.79	$860.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $77.53 / $122.55 / $160.26	Professional	26	$77.53	$122.55	$160.26
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $424.82 / $694.80	Professional	TC	$210.00	$424.82	$694.80
United Facility/Professional Professional Modifier Low / Median / High Price $279.16 / $449.74 / $780.90	Professional		$279.16	$449.74	$780.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.84 / $82.78 / $213.30	Professional	26	$78.84	$82.78	$213.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.32 / $366.96 / $581.50	Professional	TC	$200.32	$366.96	$581.50