Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.78 / $294.55 / $346.44	Professional		$190.78	$294.55	$346.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $67.76 / $291.70	Professional	26	$54.86	$67.76	$291.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.64 / $226.80 / $282.38	Professional	TC	$126.64	$226.80	$282.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $94.12 / $280.77	Professional		$94.12	$94.12	$280.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.12 / $94.12 / $116.35	Facility	26	$94.12	$94.12	$116.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.32 / $353.23 / $459.71	Professional		$250.32	$353.23	$459.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.97 / $94.12 / $148.37	Professional	26	$60.97	$94.12	$148.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.70 / $269.02 / $337.95	Professional	TC	$165.70	$269.02	$337.95
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $94.12 / $94.12 / $116.35	Facility	26	$94.12	$94.12	$116.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $175.01 / $291.70 / $451.68	Professional		$175.01	$291.70	$451.68
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $60.97 / $94.12 / $123.83	Professional	26	$60.97	$94.12	$123.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $165.57 / $207.19 / $280.45	Professional	TC	$165.57	$207.19	$280.45
United Facility/Professional Professional Modifier Low / Median / High Price $165.04 / $262.33 / $340.98	Professional		$165.04	$262.33	$340.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $55.80 / $114.08	Professional	26	$55.22	$55.80	$114.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.82 / $198.33 / $274.11	Professional	TC	$109.82	$198.33	$274.11