Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $234.42 / $1,479.11	Professional		$123.03	$234.42	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $28.18 / $154.88	Professional	26	$14.13	$28.18	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $173.78 / $1,348.96	Professional	TC	$107.15	$173.78	$1,348.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $131.83 / $245.47	Professional		$16.60	$131.83	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $281.84	Professional		$112.20	$204.17	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $57.54 / $85.11	Professional	26	$20.42	$57.54	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $154.88 / $194.98	Professional	TC	$83.18	$154.88	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $263.03 / $537.03	Professional		$194.98	$263.03	$537.03
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $60.26 / $85.11	Professional	26	$23.44	$60.26	$85.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $169.82 / $199.53	Professional	TC	$141.25	$169.82	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $109.65 / $316.23	Professional		$97.72	$109.65	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $30.20 / $48.98	Professional	26	$15.49	$30.20	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $93.33 / $239.88	Professional	TC	$66.07	$93.33	$239.88