Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $284.45 / $284.45 / $284.45	Facility	26	$284.45	$284.45	$284.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.77 / $475.00 / $1,701.00	Professional		$215.77	$475.00	$1,701.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.30 / $140.00 / $388.22	Professional	26	$70.30	$140.00	$388.22
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $101.07 / $187.50 / $644.72	Professional	52	$101.07	$187.50	$644.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.99 / $335.00 / $565.00	Professional	TC	$140.99	$335.00	$565.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $109.37 / $318.11	Professional		$109.37	$109.37	$318.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.37 / $109.37 / $135.19	Facility	26	$109.37	$109.37	$135.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $318.11 / $477.95 / $616.05	Professional		$318.11	$477.95	$616.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $109.37 / $174.14	Professional	26	$70.81	$109.37	$174.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.74 / $345.34 / $535.77	Professional	TC	$208.74	$345.34	$535.77
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $109.37 / $109.37 / $135.19	Facility	26	$109.37	$109.37	$135.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $208.46 / $330.53 / $538.64	Professional		$208.46	$330.53	$538.64
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $109.37 / $144.46	Professional	26	$70.81	$109.37	$144.46
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $201.83 / $252.59 / $467.83	Professional	TC	$201.83	$252.59	$467.83
United Facility/Professional Professional Modifier Low / Median / High Price $192.64 / $226.64 / $434.72	Professional		$192.64	$226.64	$434.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.22 / $64.88 / $133.72	Professional	26	$64.22	$64.88	$133.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.91 / $231.60 / $369.84	Professional	TC	$127.91	$231.60	$369.84