Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.09 / $221.85 / $221.85	Facility		$38.09	$221.85	$221.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.24 / $23.24 / $23.24	Facility	26	$23.24	$23.24	$23.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $78.00 / $153.00	Professional		$44.83	$78.00	$153.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.10 / $34.00 / $72.30	Professional	26	$28.10	$34.00	$72.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $326.11 / $326.11 / $334.86	Professional	50	$326.11	$326.11	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.05 / $32.24 / $167.43	Professional	52	$19.05	$32.24	$167.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.85 / $52.74 / $76.37	Professional	TC	$14.85	$52.74	$76.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $151.22 / $508.36 / $903.51	Facility		$151.22	$508.36	$903.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $42.99 / $103.80	Professional		$27.70	$42.99	$103.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $91.55 / $136.78	Professional		$59.64	$91.55	$136.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.16 / $41.54 / $55.20	Professional	26	$28.16	$41.54	$55.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.50 / $58.13 / $88.04	Professional	TC	$23.50	$58.13	$88.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $42.26 / $80.48	Professional		$32.34	$42.26	$80.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.09 / $96.10 / $120.13	Facility		$45.09	$96.10	$120.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.44 / $100.67 / $144.94	Professional		$60.44	$100.67	$144.94
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $29.00 / $41.21 / $52.78	Professional	26	$29.00	$41.21	$52.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.71 / $58.13 / $88.04	Professional	TC	$23.71	$58.13	$88.04
United Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $107.10 / $151.19	Professional		$73.05	$107.10	$151.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.29 / $44.01 / $71.28	Professional	26	$32.29	$44.01	$71.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.20 / $67.83 / $95.91	Professional	TC	$35.20	$67.83	$95.91