Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.17 / $46.17 / $104.58	Facility	26	$46.17	$46.17	$104.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.13 / $461.05 / $757.32	Professional		$289.13	$461.05	$757.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.17 / $59.35 / $88.53	Professional	26	$46.17	$59.35	$88.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $144.57 / $199.98 / $249.22	Professional	52	$144.57	$199.98	$249.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.96 / $401.68 / $668.76	Professional	TC	$242.96	$401.68	$668.76
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.08 / $278.00 / $476.58	Professional		$55.08	$278.00	$476.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $447.84 / $636.30 / $882.37	Professional		$447.84	$636.30	$882.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.91 / $90.38 / $124.17	Professional	26	$63.91	$90.38	$124.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $385.51 / $539.71 / $766.37	Professional	TC	$385.51	$539.71	$766.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $84.03 / $603.03	Professional		$32.34	$84.03	$603.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $447.84 / $649.37 / $890.59	Professional		$447.84	$649.37	$890.59
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $63.91 / $90.38 / $116.00	Professional	26	$63.91	$90.38	$116.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $385.51 / $529.50 / $766.37	Professional	TC	$385.51	$529.50	$766.37
United Facility/Professional Professional Modifier Low / Median / High Price $540.03 / $752.40 / $968.76	Professional		$540.03	$752.40	$968.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.70 / $102.31 / $141.76	Professional	26	$77.70	$102.31	$141.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $457.77 / $617.30 / $847.36	Professional	TC	$457.77	$617.30	$847.36