Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.60 / $375.44 / $697.48	Facility		$197.60	$375.44	$697.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $197.60 / $197.60 / $197.60	Facility	26	$197.60	$197.60	$197.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.93 / $102.79 / $201.28	Professional		$90.93	$102.79	$201.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.85 / $37.75 / $71.22	Professional	26	$34.85	$37.75	$71.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.09 / $65.04 / $122.67	Professional	TC	$56.09	$65.04	$122.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $72.56 / $136.66	Professional		$30.53	$72.56	$136.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $115.15 / $166.65	Professional		$64.09	$115.15	$166.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.69 / $46.66 / $67.08	Professional	26	$28.69	$46.66	$67.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.67 / $74.45 / $99.57	Professional	TC	$52.67	$74.45	$99.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $72.37 / $134.77	Professional		$32.34	$72.37	$134.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $82.99 / $100.16 / $155.94	Facility		$82.99	$100.16	$155.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $94.49 / $150.19 / $266.93	Professional		$94.49	$150.19	$266.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $46.66 / $67.08	Professional	26	$33.29	$46.66	$67.08
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $60.31 / $74.45 / $99.57	Professional	TC	$60.31	$74.45	$99.57
United Facility/Professional Professional Modifier Low / Median / High Price $60.17 / $64.31 / $171.50	Professional		$60.17	$64.31	$171.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.09 / $24.33 / $69.94	Professional	26	$22.09	$24.33	$69.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.71 / $42.22 / $112.60	Professional	TC	$37.71	$42.22	$112.60