Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.80 / $262.80 / $262.80	Facility		$262.80	$262.80	$262.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $167.94 / $546.00	Professional		$140.13	$167.94	$546.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.25 / $43.81 / $60.16	Professional	26	$40.25	$43.81	$60.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $108.87 / $220.72	Professional	TC	$98.17	$108.87	$220.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $615.19 / $77,999.99 / $94,999.99	Facility		$615.19	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.52 / $61.52 / $298.13	Professional		$61.52	$61.52	$298.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $298.13 / $298.13 / $298.13	Facility		$298.13	$298.13	$298.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.52 / $61.52 / $61.52	Facility	26	$61.52	$61.52	$61.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.91 / $298.13 / $315.70	Professional		$183.91	$298.13	$315.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.52 / $61.52 / $95.82	Professional	26	$61.52	$61.52	$95.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.56 / $236.61 / $236.61	Professional	TC	$117.56	$236.61	$236.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.83 / $251.10 / $298.13	Facility		$128.83	$251.10	$298.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $61.52 / $61.52 / $61.52	Facility	26	$61.52	$61.52	$61.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $184.22 / $271.31 / $414.40	Professional		$184.22	$271.31	$414.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $61.52 / $61.52 / $95.82	Professional	26	$61.52	$61.52	$95.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $117.56 / $236.61 / $236.61	Professional	TC	$117.56	$236.61	$236.61
United Facility/Professional Professional Modifier Low / Median / High Price $194.81 / $267.37 / $479.17	Professional		$194.81	$267.37	$479.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.32 / $69.59 / $108.23	Professional	26	$60.32	$69.59	$108.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.53 / $193.20 / $322.07	Professional	TC	$152.53	$193.20	$322.07