Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.86 / $101.86 / $164.83	Facility		$101.86	$101.86	$164.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.63 / $31.63 / $31.63	Facility	26	$31.63	$31.63	$31.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $121.83 / $148.47	Professional		$113.82	$121.83	$148.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $22.46 / $28.97	Professional	26	$11.77	$22.46	$28.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.93 / $105.09 / $128.52	Professional	TC	$96.93	$105.09	$128.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $430.48 / $535.11 / $846.57	Facility		$430.48	$535.11	$846.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.77 / $100.11 / $140.68	Professional		$13.77	$100.11	$140.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $147.68 / $147.68	Facility		$147.68	$147.68	$147.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.58 / $240.15 / $348.68	Professional		$148.58	$240.15	$348.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $23.68 / $42.99	Professional	26	$15.39	$23.68	$42.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.38 / $203.90 / $326.08	Professional	TC	$132.38	$203.90	$326.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $35.77 / $200.36	Professional		$32.34	$35.77	$200.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $118.41 / $148.01 / $260.16	Facility		$118.41	$148.01	$260.16
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $161.22 / $280.17 / $398.93	Professional		$161.22	$280.17	$398.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.39 / $23.68 / $42.26	Professional	26	$15.39	$23.68	$42.26
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $133.58 / $215.39 / $326.08	Professional	TC	$133.58	$215.39	$326.08
United Facility/Professional Professional Modifier Low / Median / High Price $147.40 / $248.73 / $343.44	Professional		$147.40	$248.73	$343.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.51 / $28.45 / $46.90	Professional	26	$16.51	$28.45	$46.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.47 / $217.12 / $314.14	Professional	TC	$132.47	$217.12	$314.14