Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.77 / $62.60 / $91.73	Professional		$49.77	$62.60	$91.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $28.91 / $43.42	Professional	26	$20.61	$28.91	$43.42
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.42 / $43.42 / $43.42	Professional	50	$43.42	$43.42	$43.42
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.92 / $33.18 / $44.17	Professional	52	$23.92	$33.18	$44.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.22 / $39.71 / $52.82	Professional	TC	$27.22	$39.71	$52.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $428.42 / $504.85 / $526.85	Facility		$428.42	$504.85	$526.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $43.59 / $57.55	Professional		$18.80	$43.59	$57.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.65 / $92.97 / $149.56	Professional		$58.65	$92.97	$149.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $31.13 / $50.08	Professional	26	$22.02	$31.13	$50.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $61.84 / $99.47	Professional	TC	$33.61	$61.84	$99.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $49.63 / $87.25	Professional		$32.34	$49.63	$87.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $80.29 / $105.09	Facility		$58.58	$80.29	$105.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.67 / $92.97 / $149.56	Professional		$64.67	$92.97	$149.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.05 / $32.49 / $50.08	Professional	26	$22.05	$32.49	$50.08
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $39.14 / $61.84 / $99.47	Professional	TC	$39.14	$61.84	$99.47
United Facility/Professional Professional Modifier Low / Median / High Price $64.08 / $96.47 / $138.96	Professional		$64.08	$96.47	$138.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $35.70 / $49.14	Professional	26	$23.93	$35.70	$49.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.26 / $58.00 / $89.28	Professional	TC	$32.26	$58.00	$89.28