Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.56 / $103.36 / $632.83	Facility		$99.56	$103.36	$632.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.93 / $134.71 / $254.09	Professional		$119.93	$134.71	$254.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.07 / $62.97 / $106.04	Professional	26	$58.07	$62.97	$106.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.86 / $71.73 / $135.29	Professional	TC	$61.86	$71.73	$135.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.31 / $132.87 / $238.07	Professional		$61.31	$132.87	$238.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.61 / $152.94 / $250.63	Professional		$95.61	$152.94	$250.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.59 / $84.15 / $124.23	Professional	26	$57.59	$84.15	$124.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.45 / $85.34 / $109.52	Professional	TC	$63.45	$85.34	$109.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $98.64 / $241.20	Professional		$32.34	$98.64	$241.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.20 / $135.52 / $222.18	Facility		$123.20	$135.52	$222.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $152.18 / $199.49 / $415.73	Professional		$152.18	$199.49	$415.73
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $66.84 / $84.15 / $111.10	Professional	26	$66.84	$84.15	$111.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $75.53 / $85.34 / $109.52	Professional	TC	$75.53	$85.34	$109.52
United Facility/Professional Professional Modifier Low / Median / High Price $82.56 / $94.41 / $251.76	Professional		$82.56	$94.41	$251.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.64 / $44.39 / $162.75	Professional	26	$40.64	$44.39	$162.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.59 / $50.02 / $133.38	Professional	TC	$41.59	$50.02	$133.38