Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $278.16 / $278.16 / $563.16	Facility		$278.16	$278.16	$563.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $112.56 / $189.59	Professional		$103.56	$112.56	$189.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.59 / $36.77 / $44.37	Professional	26	$34.59	$36.77	$44.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $75.78 / $145.22	Professional	TC	$68.95	$75.78	$145.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $100.94 / $218.34	Professional		$33.54	$100.94	$218.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.67 / $144.01 / $199.67	Professional		$122.67	$144.01	$199.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.28 / $43.08 / $62.41	Professional	26	$31.28	$43.08	$62.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.59 / $104.17 / $128.49	Professional	TC	$79.59	$104.17	$128.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $54.67 / $239.18	Professional		$32.34	$54.67	$239.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $200.25 / $200.25 / $200.25	Facility		$200.25	$200.25	$200.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $133.34 / $199.67 / $450.90	Professional		$133.34	$199.67	$450.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $36.58 / $46.82 / $62.41	Professional	26	$36.58	$46.82	$62.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $79.59 / $103.82 / $128.49	Professional	TC	$79.59	$103.82	$128.49
United Facility/Professional Professional Modifier Low / Median / High Price $66.66 / $105.24 / $263.10	Professional		$66.66	$105.24	$263.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.83 / $24.04 / $64.09	Professional	26	$22.83	$24.04	$64.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.83 / $81.20 / $203.01	Professional	TC	$43.83	$81.20	$203.01