Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.04 / $373.79 / $1,473.00	Professional		$300.04	$373.79	$1,473.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.56 / $110.37 / $157.30	Professional	26	$101.56	$110.37	$157.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $150.02 / $150.02 / $170.00	Professional	52	$150.02	$150.02	$170.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $206.93 / $229.43 / $410.83	Professional	TC	$206.93	$229.43	$410.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.37 / $160.37 / $573.65	Professional		$160.37	$160.37	$573.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $160.37 / $160.37 / $160.37	Facility	26	$160.37	$160.37	$160.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $358.33 / $573.65 / $573.65	Professional		$358.33	$573.65	$573.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $135.72 / $160.37 / $194.59	Professional	26	$135.72	$160.37	$194.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.61 / $413.28 / $413.28	Professional	TC	$222.61	$413.28	$413.28
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $160.37 / $160.37 / $160.37	Facility	26	$160.37	$160.37	$160.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $358.44 / $516.23 / $775.60	Professional		$358.44	$516.23	$775.60
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $135.72 / $160.37 / $194.59	Professional	26	$135.72	$160.37	$194.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $222.61 / $413.28 / $413.28	Professional	TC	$222.61	$413.28	$413.28
United Facility/Professional Professional Modifier Low / Median / High Price $465.16 / $580.01 / $1,011.96	Professional		$465.16	$580.01	$1,011.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $151.47 / $181.16 / $281.20	Professional	26	$151.47	$181.16	$281.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $308.05 / $404.85 / $730.75	Professional	TC	$308.05	$404.85	$730.75