Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.32 / $188.05 / $215.26	Facility	26	$95.32	$188.05	$215.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $580.34 / $799.35 / $1,192.58	Professional		$580.34	$799.35	$1,192.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.20 / $137.96 / $238.93	Professional	26	$118.20	$137.96	$238.93
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $137.96 / $290.17 / $418.08	Professional	52	$137.96	$290.17	$418.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $389.34 / $654.21 / $1,006.84	Professional	TC	$389.34	$654.21	$1,006.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.09 / $443.62 / $761.10	Professional		$114.09	$443.62	$761.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $714.99 / $1,036.74 / $1,255.61	Professional		$714.99	$1,036.74	$1,255.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $132.47 / $192.33 / $254.66	Professional	26	$132.47	$192.33	$254.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $585.71 / $847.58 / $1,018.57	Professional	TC	$585.71	$847.58	$1,018.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $174.04 / $887.90	Professional		$32.34	$174.04	$887.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $714.99 / $1,048.53 / $1,430.69	Professional		$714.99	$1,048.53	$1,430.69
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $132.47 / $187.46 / $237.05	Professional	26	$132.47	$187.46	$237.05
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $585.71 / $825.92 / $1,018.57	Professional	TC	$585.71	$825.92	$1,018.57
United Facility/Professional Professional Modifier Low / Median / High Price $863.04 / $1,091.40 / $1,572.90	Professional		$863.04	$1,091.40	$1,572.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $161.50 / $226.81 / $311.87	Professional	26	$161.50	$226.81	$311.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $691.20 / $900.95 / $1,283.77	Professional	TC	$691.20	$900.95	$1,283.77