Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.86 / $288.80 / $454.11	Facility		$101.86	$288.80	$454.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.80 / $30.75 / $30.75	Facility	26	$18.80	$30.75	$30.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.75 / $133.16 / $565.00	Professional		$103.75	$133.16	$565.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.37 / $24.71 / $55.02	Professional	26	$20.37	$24.71	$55.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.75 / $105.01 / $175.65	Professional	TC	$76.75	$105.01	$175.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $145.94 / $508.46 / $871.96	Facility		$145.94	$508.46	$871.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.12 / $80.53 / $152.97	Professional		$17.12	$80.53	$152.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.25 / $88.25 / $88.25	Facility		$88.25	$88.25	$88.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.19 / $191.61 / $272.41	Professional		$128.19	$191.61	$272.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $30.59 / $40.85	Professional	26	$22.84	$30.59	$40.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.76 / $159.15 / $235.27	Professional	TC	$103.76	$159.15	$235.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $36.15 / $170.48	Professional		$32.34	$36.15	$170.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $108.25 / $161.36 / $232.23	Facility		$108.25	$161.36	$232.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $131.19 / $224.87 / $301.36	Professional		$131.19	$224.87	$301.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $23.64 / $31.26 / $40.85	Professional	26	$23.64	$31.26	$40.85
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $105.90 / $159.15 / $235.27	Professional	TC	$105.90	$159.15	$235.27
United Facility/Professional Facility Modifier Low / Median / High Price $110.74 / $110.74 / $110.74	Facility		$110.74	$110.74	$110.74
United Facility/Professional Professional Modifier Low / Median / High Price $141.94 / $226.20 / $297.55	Professional		$141.94	$226.20	$297.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.66 / $35.00 / $49.26	Professional	26	$26.66	$35.00	$49.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.69 / $189.00 / $253.70	Professional	TC	$119.69	$189.00	$253.70