Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.18 / $339.29 / $639.96	Professional		$300.18	$339.29	$639.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.23 / $128.31 / $220.62	Professional	26	$118.23	$128.31	$220.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.94 / $210.96 / $397.93	Professional	TC	$181.94	$210.96	$397.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.59 / $296.13 / $526.12	Professional		$126.59	$296.13	$526.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.20 / $408.30 / $639.58	Professional		$179.20	$408.30	$639.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.04 / $171.16 / $259.31	Professional	26	$119.04	$171.16	$259.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $219.25 / $266.42 / $333.27	Professional	TC	$219.25	$266.42	$333.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $203.73 / $598.50	Professional		$32.34	$203.73	$598.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $379.61 / $528.15 / $1,150.70	Professional		$379.61	$528.15	$1,150.70
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $171.16 / $227.53	Professional	26	$138.04	$171.16	$227.53
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $222.14 / $270.26 / $333.27	Professional	TC	$222.14	$270.26	$333.27
United Facility/Professional Professional Modifier Low / Median / High Price $205.69 / $256.60 / $641.49	Professional		$205.69	$256.60	$641.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.38 / $91.60 / $244.26	Professional	26	$83.38	$91.60	$244.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.31 / $165.00 / $440.00	Professional	TC	$122.31	$165.00	$440.00