Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $210.99 / $210.99 / $210.99	Facility	26	$210.99	$210.99	$210.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.59 / $314.01 / $1,255.48	Professional		$202.59	$314.01	$1,255.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $91.46 / $292.60	Professional	26	$62.95	$91.46	$292.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.94 / $251.06 / $473.56	Professional	TC	$132.94	$251.06	$473.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.01 / $102.01 / $298.13	Professional		$102.01	$102.01	$298.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.01 / $102.01 / $126.10	Facility	26	$102.01	$102.01	$126.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.11 / $333.60 / $472.55	Professional		$296.11	$333.60	$472.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.27 / $102.01 / $161.37	Professional	26	$66.27	$102.01	$161.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.12 / $249.46 / $357.16	Professional	TC	$196.12	$249.46	$357.16
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $102.01 / $102.01 / $126.10	Facility	26	$102.01	$102.01	$126.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $201.54 / $310.04 / $481.01	Professional		$201.54	$310.04	$481.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $66.27 / $102.01 / $134.80	Professional	26	$66.27	$102.01	$134.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $196.12 / $221.58 / $294.67	Professional	TC	$196.12	$221.58	$294.67
United Facility/Professional Professional Modifier Low / Median / High Price $174.85 / $259.83 / $364.80	Professional		$174.85	$259.83	$364.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.13 / $60.50 / $124.23	Professional	26	$60.13	$60.50	$124.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.72 / $199.33 / $253.36	Professional	TC	$114.72	$199.33	$253.36