Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.33 / $49.33 / $108.78	Facility	26	$49.33	$49.33	$108.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $194.27 / $238.19	Professional		$94.34	$194.27	$238.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $53.53 / $122.50	Professional	26	$49.65	$53.53	$122.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.02 / $144.61 / $180.05	Professional	TC	$45.02	$144.61	$180.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $104.77 / $195.96	Professional		$53.38	$104.77	$195.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $258.86 / $403.47	Professional		$116.13	$258.86	$403.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.53 / $79.62 / $111.50	Professional	26	$56.53	$79.62	$111.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.72 / $179.58 / $342.88	Professional	TC	$56.72	$179.58	$342.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $71.58 / $151.58	Professional		$32.34	$71.58	$151.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $153.47 / $258.86 / $352.05	Professional		$153.47	$258.86	$352.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $57.44 / $80.16 / $105.34	Professional	26	$57.44	$80.16	$105.34
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $60.59 / $179.58 / $239.45	Professional	TC	$60.59	$179.58	$239.45
United Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $263.83 / $374.45	Professional		$141.47	$263.83	$374.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.48 / $71.81 / $140.05	Professional	26	$55.48	$71.81	$140.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.65 / $155.40 / $319.11	Professional	TC	$69.65	$155.40	$319.11