Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $97.72 / $144.54	Professional		$81.28	$97.72	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $52.48 / $83.18	Professional	TC	$39.81	$52.48	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $204.17	Professional		$104.71	$147.91	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $74.13 / $107.15	Professional	TC	$54.95	$74.13	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $100.00	Professional		$32.36	$33.11	$100.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $190.55	Professional		$104.71	$134.90	$190.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $67.61 / $102.33	Professional	TC	$54.95	$67.61	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $223.87	Professional		$100.00	$138.04	$223.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $69.18 / $114.82	Professional	TC	$43.65	$69.18	$114.82