Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.02 / $475.00 / $1,742.69	Professional		$299.02	$475.00	$1,742.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.16 / $140.00 / $322.00	Professional	26	$85.16	$140.00	$322.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $139.56 / $172.18 / $894.67	Professional	52	$139.56	$172.18	$894.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $193.96 / $335.00 / $565.00	Professional	TC	$193.96	$335.00	$565.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.44 / $131.44 / $438.52	Professional		$131.44	$131.44	$438.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.44 / $131.44 / $162.50	Facility	26	$131.44	$131.44	$162.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.46 / $615.64 / $855.29	Professional		$432.46	$615.64	$855.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.57 / $131.44 / $208.68	Professional	26	$85.57	$131.44	$208.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $307.07 / $457.54 / $623.94	Professional	TC	$307.07	$457.54	$623.94
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $131.44 / $131.44 / $162.50	Facility	26	$131.44	$131.44	$162.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $291.20 / $457.24 / $722.66	Professional		$291.20	$457.24	$722.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $85.57 / $131.44 / $174.82	Professional	26	$85.57	$131.44	$174.82
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $298.61 / $373.64 / $530.07	Professional	TC	$298.61	$373.64	$530.07
United Facility/Professional Professional Modifier Low / Median / High Price $266.58 / $476.47 / $556.16	Professional		$266.58	$476.47	$556.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.30 / $78.02 / $160.36	Professional	26	$77.30	$78.02	$160.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.96 / $338.80 / $480.24	Professional	TC	$188.96	$338.80	$480.24