Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.81 / $52.81 / $52.81	Facility		$52.81	$52.81	$52.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.98 / $14.98 / $14.98	Facility	26	$14.98	$14.98	$14.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.81 / $118.81 / $174.55	Professional		$52.81	$118.81	$174.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.98 / $16.73 / $28.46	Professional	26	$14.98	$16.73	$28.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.83 / $114.40 / $154.11	Professional	TC	$37.83	$114.40	$154.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $271.29 / $994.77 / $1,620.96	Facility		$271.29	$994.77	$1,620.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.91 / $45.93 / $91.59	Professional		$16.91	$45.93	$91.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.45 / $150.78 / $259.32	Professional		$93.45	$150.78	$259.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $26.22 / $37.88	Professional	26	$19.73	$26.22	$37.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.23 / $125.85 / $205.38	Professional	TC	$67.23	$125.85	$205.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.79 / $32.34 / $96.77	Professional		$25.79	$32.34	$96.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $59.37 / $90.31 / $143.69	Facility		$59.37	$90.31	$143.69
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.61 / $145.86 / $234.34	Professional		$86.61	$145.86	$234.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $25.23 / $33.03	Professional	26	$19.73	$25.23	$33.03
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $67.23 / $131.32 / $234.23	Professional	TC	$67.23	$131.32	$234.23
United Facility/Professional Professional Modifier Low / Median / High Price $90.24 / $139.16 / $255.60	Professional		$90.24	$139.16	$255.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.08 / $29.90 / $41.87	Professional	26	$22.08	$29.90	$41.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.15 / $112.80 / $211.68	Professional	TC	$66.15	$112.80	$211.68