Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.75 / $171.32 / $280.63	Professional		$155.75	$171.32	$280.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $59.07 / $90.52	Professional	26	$53.70	$59.07	$90.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.06 / $112.26 / $190.10	Professional	TC	$102.06	$112.26	$190.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.49 / $91.49 / $108.75	Facility	26	$91.49	$91.49	$108.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.92 / $516.34 / $683.79	Professional		$258.92	$516.34	$683.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.33 / $91.49 / $130.28	Professional	26	$59.33	$91.49	$130.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.52 / $424.85 / $559.33	Professional	TC	$196.52	$424.85	$559.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $91.49 / $91.49 / $108.75	Facility	26	$91.49	$91.49	$108.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $330.52 / $554.65 / $847.29	Professional		$330.52	$554.65	$847.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $62.41 / $91.49 / $102.11	Professional	26	$62.41	$91.49	$102.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $260.85 / $424.85 / $461.97	Professional	TC	$260.85	$424.85	$461.97
United Facility/Professional Professional Modifier Low / Median / High Price $422.88 / $510.98 / $572.65	Professional		$422.88	$510.98	$572.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.08 / $97.46 / $111.14	Professional	26	$82.08	$97.46	$111.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $340.80 / $412.34 / $461.51	Professional	TC	$340.80	$412.34	$461.51