Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $107.15 / $107.15	Facility	26	$102.33	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $251.19 / $794.33	Professional		$162.18	$251.19	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $85.11 / $199.53	Professional	26	$51.29	$85.11	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $162.18 / $371.54	Professional	TC	$112.20	$162.18	$371.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $154.88 / $338.84	Professional		$69.18	$154.88	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $501.19	Professional		$199.53	$302.00	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $100.00 / $144.54	Professional	26	$61.66	$100.00	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $199.53 / $295.12	Professional	TC	$128.82	$199.53	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $257.04	Professional		$32.36	$33.11	$257.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $380.19 / $549.54	Professional		$223.87	$380.19	$549.54
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $102.33 / $144.54	Professional	26	$70.79	$102.33	$144.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $223.87 / $295.12	Professional	TC	$141.25	$223.87	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $676.08 / $1,380.38	Professional		$218.78	$676.08	$1,380.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $70.79 / $158.49	Professional	26	$66.07	$70.79	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $602.56 / $1,122.02	Professional	TC	$147.91	$602.56	$1,122.02