Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.08 / $51.29	Professional	26	$5.75	$7.08	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $22.91 / $141.25	Professional	TC	$19.05	$22.91	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $45.71	Facility	26	$38.02	$38.02	$45.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.67 / $85.11	Professional	26	$24.55	$34.67	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $109.65 / $275.42	Professional	TC	$81.28	$109.65	$275.42
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $45.71	Facility	26	$38.02	$38.02	$45.71
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.67 / $53.70	Professional	26	$24.55	$34.67	$53.70
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $109.65 / $169.82	Professional	TC	$81.28	$109.65	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $33.88 / $45.71	Professional	26	$26.92	$33.88	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $107.15 / $144.54	Professional	TC	$91.20	$107.15	$144.54