Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.38 / $143.61 / $757.49	Professional		$117.38	$143.61	$757.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.98 / $119.54 / $621.63	Professional	TC	$97.98	$119.54	$621.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.75 / $35.75 / $44.20	Facility	26	$35.75	$35.75	$44.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.49 / $171.12 / $279.74	Professional		$104.49	$171.12	$279.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.13 / $134.22 / $221.35	Professional	TC	$78.13	$134.22	$221.35
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $35.75 / $35.75 / $44.20	Facility	26	$35.75	$35.75	$44.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $138.62 / $223.47 / $356.15	Professional		$138.62	$223.47	$356.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $83.19 / $143.03 / $205.99	Professional	TC	$83.19	$143.03	$205.99
United Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $132.09 / $231.97	Professional		$111.36	$132.09	$231.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.91 / $107.55 / $188.87	Professional	TC	$85.91	$107.55	$188.87