Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.95 / $49.35 / $49.35	Facility	26	$30.95	$49.35	$49.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.88 / $232.99 / $808.75	Professional		$133.88	$232.99	$808.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.50 / $62.59 / $236.71	Professional	26	$38.50	$62.59	$236.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.05 / $162.12 / $293.55	Professional	TC	$87.05	$162.12	$293.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.09 / $108.32 / $196.64	Professional		$27.09	$108.32	$196.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.00 / $250.50 / $354.88	Professional		$167.00	$250.50	$354.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.04 / $69.06 / $102.11	Professional	26	$44.04	$69.06	$102.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.45 / $178.62 / $252.77	Professional	TC	$124.45	$178.62	$252.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $58.06 / $216.81	Professional		$32.34	$58.06	$216.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $176.93 / $302.69 / $390.02	Professional		$176.93	$302.69	$390.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $44.97 / $69.06 / $102.11	Professional	26	$44.97	$69.06	$102.11
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $131.75 / $178.62 / $252.77	Professional	TC	$131.75	$178.62	$252.77
United Facility/Professional Professional Modifier Low / Median / High Price $198.71 / $296.45 / $397.42	Professional		$198.71	$296.45	$397.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.72 / $79.52 / $105.61	Professional	26	$49.72	$79.52	$105.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.25 / $217.00 / $284.32	Professional	TC	$152.25	$217.00	$284.32