Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.89 / $475.00 / $1,502.21	Professional		$252.89	$475.00	$1,502.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.20 / $140.00 / $282.00	Professional	26	$70.20	$140.00	$282.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $119.41 / $187.50 / $771.22	Professional	52	$119.41	$187.50	$771.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $179.15 / $335.00 / $565.00	Professional	TC	$179.15	$335.00	$565.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.31 / $108.31 / $371.74	Professional		$108.31	$108.31	$371.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.31 / $108.31 / $133.90	Facility	26	$108.31	$108.31	$133.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.74 / $550.85 / $721.06	Professional		$371.74	$550.85	$721.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.70 / $108.31 / $171.71	Professional	26	$69.70	$108.31	$171.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.43 / $443.89 / $530.35	Professional	TC	$263.43	$443.89	$530.35
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $108.31 / $108.31 / $133.90	Facility	26	$108.31	$108.31	$133.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $254.46 / $404.64 / $612.85	Professional		$254.46	$404.64	$612.85
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $69.70 / $108.31 / $143.91	Professional	26	$69.70	$108.31	$143.91
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $263.43 / $403.89 / $491.79	Professional	TC	$263.43	$403.89	$491.79
United Facility/Professional Professional Modifier Low / Median / High Price $229.76 / $411.95 / $558.62	Professional		$229.76	$411.95	$558.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.61 / $64.25 / $131.84	Professional	26	$63.61	$64.25	$131.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.95 / $313.77 / $471.74	Professional	TC	$165.95	$313.77	$471.74