Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.63 / $137.80 / $285.00	Facility		$128.63	$137.80	$285.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $37.21 / $176.47	Professional		$33.50	$37.21	$176.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.82 / $11.28 / $37.79	Professional	26	$8.82	$11.28	$37.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $25.92 / $47.26	Professional	TC	$22.87	$25.92	$47.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.90 / $77,999.99 / $94,999.99	Facility		$223.90	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.67 / $13.67 / $57.31	Professional		$13.67	$13.67	$57.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.74 / $56.79 / $76.03	Facility		$43.74	$56.79	$76.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.67 / $13.67 / $16.89	Facility	26	$13.67	$13.67	$16.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $43.12 / $43.12 / $53.30	Facility	TC	$43.12	$43.12	$53.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.69 / $55.24 / $85.32	Professional		$35.69	$55.24	$85.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $13.67 / $24.74	Professional	26	$11.86	$13.67	$24.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.75 / $37.04 / $57.29	Professional	TC	$23.75	$37.04	$57.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.86 / $57.23 / $76.03	Facility		$35.86	$57.23	$76.03
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.67 / $13.67 / $16.89	Facility	26	$13.67	$13.67	$16.89
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $43.12 / $43.12 / $53.30	Facility	TC	$43.12	$43.12	$53.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $57.69 / $90.50	Professional		$34.96	$57.69	$90.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $16.82 / $21.10	Professional	26	$11.10	$16.82	$21.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.47 / $39.28 / $52.83	Professional	TC	$23.47	$39.28	$52.83
United Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $36.15 / $63.38	Professional		$35.40	$36.15	$63.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.17 / $19.07	Professional	26	$10.47	$12.17	$19.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $25.62 / $44.99	Professional	TC	$23.23	$25.62	$44.99