Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $117.49 / $117.49	Facility	26	$112.20	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $295.12 / $812.83	Professional		$204.17	$295.12	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $89.13 / $275.42	Professional	26	$67.61	$89.13	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $426.58	Professional	TC	$131.83	$204.17	$426.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $162.18 / $288.40	Professional		$58.88	$162.18	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $338.84 / $562.34	Professional		$218.78	$338.84	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $104.71 / $154.88	Professional	26	$66.07	$104.71	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $229.09 / $407.38	Professional	TC	$141.25	$229.09	$407.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $269.15	Professional		$32.36	$33.11	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $426.58 / $630.96	Professional		$223.87	$426.58	$630.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $107.15 / $154.88	Professional	26	$75.86	$107.15	$154.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $257.04 / $354.81	Professional	TC	$158.49	$257.04	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $537.03	Professional		$213.80	$269.15	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $75.86 / $173.78	Professional	26	$70.79	$75.86	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $194.98 / $380.19	Professional	TC	$138.04	$194.98	$380.19