Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $357.20 / $563.16 / $687.04	Facility		$357.20	$563.16	$687.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.82 / $121.56 / $229.30	Professional		$107.82	$121.56	$229.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.43 / $48.07 / $90.68	Professional	26	$44.43	$48.07	$90.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.39 / $73.48 / $148.97	Professional	TC	$63.39	$73.48	$148.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.59 / $92.02 / $155.35	Professional		$36.59	$92.02	$155.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.95 / $136.76 / $217.71	Professional		$95.95	$136.76	$217.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.44 / $59.39 / $95.49	Professional	26	$34.44	$59.39	$95.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.51 / $77.38 / $107.65	Professional	TC	$61.51	$77.38	$107.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $58.68 / $166.70	Professional		$32.34	$58.68	$166.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.55 / $121.62 / $160.32	Facility		$102.55	$121.62	$160.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.75 / $178.39 / $319.24	Professional		$116.75	$178.39	$319.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $59.39 / $83.99	Professional	26	$39.90	$59.39	$83.99
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $70.70 / $84.10 / $107.65	Professional	TC	$70.70	$84.10	$107.65
United Facility/Professional Professional Modifier Low / Median / High Price $72.13 / $76.44 / $191.10	Professional		$72.13	$76.44	$191.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.42 / $31.39 / $79.80	Professional	26	$26.42	$31.39	$79.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.82 / $50.02 / $133.38	Professional	TC	$39.82	$50.02	$133.38