Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.04 / $40.04 / $94.00	Facility	26	$40.04	$40.04	$94.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $174.28 / $233.94	Professional		$109.44	$174.28	$233.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.04 / $54.43 / $75.20	Professional	26	$40.04	$54.43	$75.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.40 / $121.69 / $165.99	Professional	TC	$69.40	$121.69	$165.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.57 / $92.24 / $202.81	Professional		$40.57	$92.24	$202.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.43 / $219.08 / $323.44	Professional		$129.43	$219.08	$323.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.53 / $62.30 / $89.21	Professional	26	$39.53	$62.30	$89.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.40 / $154.34 / $234.23	Professional	TC	$84.40	$154.34	$234.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $55.51 / $147.88	Professional		$32.34	$55.51	$147.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $155.03 / $250.92 / $357.25	Professional		$155.03	$250.92	$357.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $63.18 / $82.54	Professional	26	$41.27	$63.18	$82.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $84.40 / $154.34 / $234.23	Professional	TC	$84.40	$154.34	$234.23
United Facility/Professional Professional Modifier Low / Median / High Price $124.85 / $174.13 / $353.48	Professional		$124.85	$174.13	$353.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $42.30 / $109.02	Professional	26	$39.90	$42.30	$109.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.82 / $131.84 / $234.89	Professional	TC	$82.82	$131.84	$234.89