Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.68 / $94.28 / $94.28	Facility	26	$49.68	$94.28	$94.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.06 / $102.50 / $377.00	Professional		$88.06	$102.50	$377.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.68 / $69.17 / $153.54	Professional	26	$49.68	$69.17	$153.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.51 / $38.38 / $79.88	Professional	TC	$30.51	$38.38	$79.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.79 / $81.50 / $155.90	Professional		$55.79	$81.50	$155.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.20 / $129.08 / $188.10	Professional		$92.20	$129.08	$188.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.81 / $88.65 / $127.05	Professional	26	$64.81	$88.65	$127.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.12 / $42.47 / $79.11	Professional	TC	$30.12	$42.47	$79.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $61.23 / $146.33	Professional		$32.34	$61.23	$146.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.42 / $141.16 / $273.61	Professional		$101.42	$141.16	$273.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $64.81 / $86.52 / $116.98	Professional	26	$64.81	$86.52	$116.98
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.12 / $42.47 / $62.24	Professional	TC	$30.12	$42.47	$62.24
United Facility/Professional Professional Modifier Low / Median / High Price $112.40 / $143.31 / $194.59	Professional		$112.40	$143.31	$194.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.00 / $97.20 / $127.80	Professional	26	$72.00	$97.20	$127.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.83 / $48.36 / $71.08	Professional	TC	$37.83	$48.36	$71.08