Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.65 / $16.16 / $16.16	Facility	26	$9.65	$16.16	$16.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.67 / $108.70 / $430.00	Professional		$71.67	$108.70	$430.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $13.35 / $57.00	Professional	26	$9.65	$13.35	$57.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.10 / $46.02 / $229.70	Professional	52	$33.10	$46.02	$229.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.53 / $103.19 / $140.86	Professional	TC	$56.53	$103.19	$140.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $8.56 / $55.93 / $104.28	Professional		$8.56	$55.93	$104.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.08 / $131.37 / $178.66	Professional		$84.08	$131.37	$178.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $16.89 / $22.33	Professional	26	$12.14	$16.89	$22.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.42 / $112.65 / $158.13	Professional	TC	$74.42	$112.65	$158.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.13 / $32.34 / $119.20	Professional		$17.13	$32.34	$119.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $91.47 / $153.88 / $190.95	Professional		$91.47	$153.88	$190.95
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $16.89 / $22.33	Professional	26	$12.37	$16.89	$22.33
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $76.59 / $116.28 / $158.13	Professional	TC	$76.59	$116.28	$158.13
United Facility/Professional Professional Modifier Low / Median / High Price $105.61 / $163.49 / $207.08	Professional		$105.61	$163.49	$207.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.29 / $18.55 / $27.65	Professional	26	$14.29	$18.55	$27.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.77 / $143.58 / $191.17	Professional	TC	$89.77	$143.58	$191.17