Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.85 / $246.41 / $730.00	Professional		$145.85	$246.41	$730.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.60 / $55.00 / $214.00	Professional	26	$49.60	$55.00	$214.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.97 / $173.87 / $216.49	Professional	TC	$90.97	$173.87	$216.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $80.45 / $215.05	Professional		$80.45	$80.45	$215.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.45 / $80.45 / $99.45	Facility	26	$80.45	$80.45	$99.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.18 / $268.79 / $360.44	Professional		$191.18	$268.79	$360.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.25 / $80.42 / $126.94	Professional	26	$52.25	$80.42	$126.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.15 / $202.24 / $264.25	Professional	TC	$126.15	$202.24	$264.25
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $80.45 / $80.45 / $99.45	Facility	26	$80.45	$80.45	$99.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $133.28 / $222.15 / $354.40	Professional		$133.28	$222.15	$354.40
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $52.25 / $80.45 / $105.19	Professional	26	$52.25	$80.45	$105.19
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $118.63 / $148.41 / $219.46	Professional	TC	$118.63	$148.41	$219.46
United Facility/Professional Professional Modifier Low / Median / High Price $125.47 / $207.17 / $259.23	Professional		$125.47	$207.17	$259.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.24 / $47.96 / $97.61	Professional	26	$47.24	$47.96	$97.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.23 / $135.16 / $163.19	Professional	TC	$78.23	$135.16	$163.19