Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.00 / $265.00 / $291.50	Professional	26	$90.00	$265.00	$291.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.21 / $157.21 / $194.35	Facility	26	$157.21	$157.21	$194.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.73 / $157.21 / $298.81	Professional	26	$107.73	$157.21	$298.81
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $157.21 / $157.21 / $194.35	Facility	26	$157.21	$157.21	$194.35
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $108.33 / $157.21 / $216.57	Professional	26	$108.33	$157.21	$216.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.34 / $98.10 / $280.27	Professional	26	$92.34	$98.10	$280.27