Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.09 / $46.20 / $513.79	Facility		$44.09	$46.20	$513.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.59 / $50.48 / $50.48	Facility	26	$30.59	$50.48	$50.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.94 / $206.08 / $902.00	Professional		$162.94	$206.08	$902.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.60 / $37.10 / $58.20	Professional	26	$30.60	$37.10	$58.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.65 / $162.49 / $265.99	Professional	TC	$116.65	$162.49	$265.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $232.60 / $810.43 / $1,389.81	Facility		$232.60	$810.43	$1,389.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.98 / $123.20 / $234.03	Professional		$31.98	$123.20	$234.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.32 / $134.32 / $134.32	Facility		$134.32	$134.32	$134.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.33 / $277.82 / $393.58	Professional		$185.33	$277.82	$393.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $46.14 / $62.51	Professional	26	$35.22	$46.14	$62.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.41 / $238.27 / $337.55	Professional	TC	$158.41	$238.27	$337.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $60.13 / $263.54	Professional		$32.34	$60.13	$263.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $169.73 / $232.05 / $335.55	Facility		$169.73	$232.05	$335.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $203.46 / $346.24 / $437.64	Professional		$203.46	$346.24	$437.64
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $49.44 / $62.51	Professional	26	$35.22	$49.44	$62.51
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $158.85 / $238.27 / $337.55	Professional	TC	$158.85	$238.27	$337.55
United Facility/Professional Professional Modifier Low / Median / High Price $220.80 / $326.39 / $433.33	Professional		$220.80	$326.39	$433.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.42 / $54.41 / $78.81	Professional	26	$40.42	$54.41	$78.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $170.14 / $278.81 / $370.19	Professional	TC	$170.14	$278.81	$370.19