Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.44 / $233.65 / $323.00	Facility		$155.44	$233.65	$323.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $35.61 / $130.00	Professional		$29.19	$35.61	$130.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $10.97 / $35.10	Professional	26	$9.41	$10.97	$35.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $22.51 / $53.37	Professional	TC	$19.76	$22.51	$53.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $207.14 / $77,999.99 / $94,999.99	Facility		$207.14	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.30 / $16.30 / $57.84	Professional		$16.30	$16.30	$57.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.91 / $57.84 / $72.84	Facility		$41.91	$57.84	$72.84
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 Professional Modifier Low / Median / High Price $32.33 / $48.21 / $79.98	Professional		$32.33	$48.21	$79.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.70 / $16.19 / $26.30	Professional	26	$10.70	$16.19	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.55 / $30.85 / $52.42	Professional	TC	$21.55	$30.85	$52.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.97 / $51.92 / $72.84	Facility		$36.97	$51.92	$72.84
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 Professional Modifier Low / Median / High Price $35.59 / $57.84 / $93.02	Professional		$35.59	$57.84	$93.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.30 / $22.00	Professional	26	$10.23	$16.30	$22.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.34 / $36.34 / $45.58	Professional	TC	$21.34	$36.34	$45.58
United Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $36.09 / $63.38	Professional		$32.08	$36.09	$63.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $11.55 / $20.28	Professional	26	$11.43	$11.55	$20.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.65 / $24.54 / $43.10	Professional	TC	$20.65	$24.54	$43.10