Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.71 / $35.71 / $35.71	Facility	26	$35.71	$35.71	$35.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.01 / $166.89 / $367.57	Professional		$113.01	$166.89	$367.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $49.63 / $103.97	Professional	26	$35.71	$49.63	$103.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.30 / $117.26 / $263.61	Professional	TC	$77.30	$117.26	$263.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.21 / $93.54 / $246.53	Professional		$38.21	$93.54	$246.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.44 / $198.92 / $238.59	Professional		$146.44	$198.92	$238.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.67 / $64.81 / $81.52	Professional	26	$47.67	$64.81	$81.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.69 / $133.38 / $159.96	Professional	TC	$101.69	$133.38	$159.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $66.16 / $199.06	Professional		$32.34	$66.16	$199.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $152.43 / $220.24 / $321.56	Professional		$152.43	$220.24	$321.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $49.43 / $65.31 / $79.58	Professional	26	$49.43	$65.31	$79.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $102.20 / $133.09 / $159.96	Professional	TC	$102.20	$133.09	$159.96
United Facility/Professional Professional Modifier Low / Median / High Price $164.64 / $231.42 / $317.52	Professional		$164.64	$231.42	$317.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.30 / $70.38 / $93.43	Professional	26	$48.30	$70.38	$93.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.41 / $162.75 / $219.53	Professional	TC	$108.41	$162.75	$219.53