Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $56.23 / $162.18	Facility	26	$56.23	$56.23	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $218.78 / $812.83	Professional		$169.82	$218.78	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $39.81 / $114.82	Professional	26	$24.55	$39.81	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $169.82 / $398.11	Professional	TC	$134.90	$169.82	$398.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $134.90 / $245.47	Professional		$27.54	$134.90	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $281.84 / $407.38	Professional		$190.55	$281.84	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $37.15 / $56.23	Professional	26	$25.12	$37.15	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $245.47 / $363.08	Professional	TC	$154.88	$245.47	$363.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $269.15	Professional		$32.36	$33.11	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $457.09	Professional		$218.78	$354.81	$457.09
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.02 / $63.10	Professional	26	$25.12	$38.02	$63.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $257.04 / $363.08	Professional	TC	$169.82	$257.04	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $338.84 / $457.09	Professional		$208.93	$338.84	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $40.74 / $72.44	Professional	26	$30.20	$40.74	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $288.40 / $398.11	Professional	TC	$169.82	$288.40	$398.11