Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.75 / $72.75 / $153.50	Facility	26	$72.75	$72.75	$153.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $645.60 / $1,099.28 / $5,496.30	Professional		$645.60	$1,099.28	$5,496.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.75 / $122.80 / $578.66	Professional	26	$72.75	$122.80	$578.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $572.85 / $905.63 / $4,917.58	Professional	TC	$572.85	$905.63	$4,917.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.07 / $555.55 / $1,221.50	Professional		$90.07	$555.55	$1,221.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $984.96 / $1,327.55 / $1,594.42	Professional		$984.96	$1,327.55	$1,594.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.07 / $136.44 / $185.33	Professional	26	$112.07	$136.44	$185.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $872.88 / $1,176.50 / $1,409.09	Professional	TC	$872.88	$1,176.50	$1,409.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $148.31 / $1,163.48	Professional		$32.34	$148.31	$1,163.48
Providence Facility/Professional Professional Modifier Low / Median / High Price $984.96 / $1,327.55 / $1,594.42	Professional		$984.96	$1,327.55	$1,594.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $112.07 / $151.05 / $185.33	Professional	26	$112.07	$151.05	$185.33
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $872.88 / $1,176.50 / $1,409.09	Professional	TC	$872.88	$1,176.50	$1,409.09
United Facility/Professional Professional Modifier Low / Median / High Price $765.79 / $847.36 / $1,863.52	Professional		$765.79	$847.36	$1,863.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.76 / $92.80 / $229.11	Professional	26	$83.76	$92.80	$229.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $681.92 / $754.56 / $1,659.43	Professional	TC	$681.92	$754.56	$1,659.43