Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.38 / $296.58 / $1,092.11	Facility		$50.38	$296.58	$1,092.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $168.13 / $168.13 / $168.13	Facility	26	$168.13	$168.13	$168.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $208.06 / $303.70 / $395.57	Facility	TC	$208.06	$303.70	$395.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $44.52 / $168.48	Professional		$36.65	$44.52	$168.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $14.51 / $46.32	Professional	26	$10.19	$14.51	$46.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.62 / $32.34 / $85.31	Professional	TC	$26.62	$32.34	$85.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.90 / $77,999.99 / $94,999.99	Facility		$223.90	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $16.82 / $63.10	Professional		$16.82	$16.82	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.21 / $63.10 / $80.31	Facility		$46.21	$63.10	$80.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.82 / $16.82 / $20.80	Facility	26	$16.82	$16.82	$20.80
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $46.27 / $46.27 / $57.20	Facility	TC	$46.27	$46.27	$57.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.86 / $50.21 / $84.85	Professional		$33.86	$50.21	$84.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.70 / $16.82 / $26.30	Professional	26	$10.70	$16.82	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.95 / $37.83 / $57.29	Professional	TC	$25.95	$37.83	$57.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.95 / $59.00 / $81.18	Facility		$39.95	$59.00	$81.18
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.82 / $16.82 / $20.80	Facility	26	$16.82	$16.82	$20.80
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $46.27 / $46.27 / $57.20	Facility	TC	$46.27	$46.27	$57.20
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $63.10 / $100.56	Professional		$38.81	$63.10	$100.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.82 / $23.51	Professional	26	$10.23	$16.82	$23.51
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.95 / $39.28 / $51.46	Professional	TC	$25.95	$39.28	$51.46
United Facility/Professional Professional Modifier Low / Median / High Price $37.78 / $38.72 / $67.81	Professional		$37.78	$38.72	$67.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $11.80 / $29.59	Professional	26	$11.46	$11.80	$29.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.63 / $27.07 / $47.54	Professional	TC	$23.63	$27.07	$47.54