Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.58 / $196.20 / $513.87	Facility		$86.58	$196.20	$513.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.36 / $42.39 / $1,146.73	Facility	26	$11.36	$42.39	$1,146.73
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $117.15 / $245.74 / $319.50	Facility	TC	$117.15	$245.74	$319.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.66 / $37.31 / $137.00	Professional		$27.66	$37.31	$137.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.48 / $47.65	Professional	26	$9.77	$14.48	$47.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.96 / $25.43 / $81.65	Professional	TC	$17.96	$25.43	$81.65
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 $16.30 / $16.30 / $53.11	Professional		$16.30	$16.30	$53.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.60 / $53.11 / $65.65	Facility		$37.60	$53.11	$65.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.30 / $16.30 / $20.14	Facility	26	$16.30	$16.30	$20.14
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $36.81 / $36.81 / $45.50	Facility	TC	$36.81	$36.81	$45.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.29 / $41.94 / $73.48	Professional		$31.29	$41.94	$73.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $14.51 / $25.56	Professional	26	$11.75	$14.51	$25.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $27.52 / $46.73	Professional	TC	$19.54	$27.52	$46.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.22 / $44.79 / $65.65	Facility		$32.22	$44.79	$65.65
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.30 / $16.30 / $20.14	Facility	26	$16.30	$16.30	$20.14
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $36.81 / $36.81 / $45.50	Facility	TC	$36.81	$36.81	$45.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.54 / $53.11 / $84.64	Professional		$32.54	$53.11	$84.64
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.30 / $21.31	Professional	26	$11.75	$16.30	$21.31
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $34.11 / $40.39	Professional	TC	$19.54	$34.11	$40.39
United Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $33.20 / $58.31	Professional		$30.79	$33.20	$58.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $11.43 / $19.66	Professional	26	$11.10	$11.43	$19.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.69 / $22.01 / $38.65	Professional	TC	$19.69	$22.01	$38.65