Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.18 / $253.19 / $897.00	Professional		$140.18	$253.19	$897.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $57.37 / $189.00	Professional	26	$39.65	$57.37	$189.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $60.63 / $78.42 / $402.88	Professional	52	$60.63	$78.42	$402.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.27 / $201.03 / $251.00	Professional	TC	$97.27	$201.03	$251.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $207.17	Professional		$63.10	$63.10	$207.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $78.00	Facility	26	$63.10	$63.10	$78.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.76 / $260.70 / $389.03	Professional		$188.76	$260.70	$389.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.16 / $63.10 / $104.78	Professional	26	$54.16	$63.10	$104.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.06 / $191.91 / $281.75	Professional	TC	$134.06	$191.91	$281.75
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $78.00	Facility	26	$63.10	$63.10	$78.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.11 / $213.52 / $341.40	Professional		$128.11	$213.52	$341.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $54.16 / $63.10 / $94.80	Professional	26	$54.16	$63.10	$94.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $126.07 / $157.72 / $216.46	Professional	TC	$126.07	$157.72	$216.46
United Facility/Professional Professional Modifier Low / Median / High Price $119.91 / $215.60 / $248.45	Professional		$119.91	$215.60	$248.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.43 / $49.84 / $111.92	Professional	26	$37.43	$49.84	$111.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.82 / $144.16 / $187.14	Professional	TC	$82.82	$144.16	$187.14