Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.81 / $233.65 / $732.33	Facility		$79.81	$233.65	$732.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.75 / $9.41 / $28.41	Facility	26	$1.75	$9.41	$28.41
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $93.96 / $207.48 / $277.58	Facility	TC	$93.96	$207.48	$277.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.87 / $21.31 / $110.00	Professional		$17.87	$21.31	$110.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.18 / $9.35 / $37.11	Professional	26	$8.18	$9.35	$37.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.74 / $11.89 / $29.88	Professional	TC	$9.74	$11.89	$29.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $47,000.00 / $81,499.99 / $94,999.99	Facility		$47,000.00	$81,499.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $13.15 / $40.49	Professional		$13.15	$13.15	$40.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.41 / $40.49 / $50.05	Facility		$28.41	$40.49	$50.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.15 / $13.15 / $16.25	Facility	26	$13.15	$13.15	$16.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.34 / $27.34 / $33.79	Facility	TC	$27.34	$27.34	$33.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $28.14 / $57.71	Professional		$20.50	$28.14	$57.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $13.15 / $21.44	Professional	26	$9.84	$13.15	$21.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.66 / $14.99 / $35.36	Professional	TC	$10.66	$14.99	$35.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $33.84 / $50.05	Facility		$25.00	$33.84	$50.05
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.15 / $13.15 / $16.25	Facility	26	$13.15	$13.15	$16.25
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $27.34 / $27.34 / $33.79	Facility	TC	$27.34	$27.34	$33.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.91 / $40.49 / $65.36	Professional		$24.91	$40.49	$65.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $13.15 / $17.89	Professional	26	$9.84	$13.15	$17.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $10.89 / $18.53 / $30.00	Professional	TC	$10.89	$18.53	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $25.98 / $45.63	Professional		$20.05	$25.98	$45.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $9.59 / $16.48	Professional	26	$9.31	$9.59	$16.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.74 / $16.60 / $29.15	Professional	TC	$10.74	$16.60	$29.15