Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.19 / $475.00 / $2,133.98	Professional		$354.19	$475.00	$2,133.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.26 / $168.21 / $606.00	Professional	26	$115.26	$168.21	$606.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $238.92 / $335.00 / $565.00	Professional	TC	$238.92	$335.00	$565.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.31 / $169.31 / $520.02	Professional		$169.31	$169.31	$520.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.31 / $169.31 / $209.30	Facility	26	$169.31	$169.31	$209.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $518.20 / $781.31 / $1,156.29	Professional		$518.20	$781.31	$1,156.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.70 / $169.31 / $267.92	Professional	26	$122.70	$169.31	$267.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $350.71 / $526.92 / $1,025.70	Professional	TC	$350.71	$526.92	$1,025.70
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $169.31 / $169.31 / $209.30	Facility	26	$169.31	$169.31	$209.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $345.71 / $543.51 / $887.04	Professional		$345.71	$543.51	$887.04
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $122.70 / $169.31 / $251.92	Professional	26	$122.70	$169.31	$251.92
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $343.70 / $430.10 / $820.28	Professional	TC	$343.70	$430.10	$820.28
United Facility/Professional Professional Modifier Low / Median / High Price $318.11 / $528.87 / $927.78	Professional		$318.11	$528.87	$927.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.70 / $113.15 / $208.00	Professional	26	$99.70	$113.15	$208.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.41 / $391.60 / $502.97	Professional	TC	$218.41	$391.60	$502.97