Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.97 / $247.95 / $376.57	Facility		$29.97	$247.95	$376.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $214.13 / $214.13 / $214.13	Facility	TC	$214.13	$214.13	$214.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $32.43 / $156.00	Professional		$26.46	$32.43	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.69 / $38.84	Professional	26	$7.33	$8.69	$38.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $23.87 / $50.25	Professional	TC	$19.14	$23.87	$50.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $183.77 / $77,999.99 / $94,999.99	Facility		$183.77	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $13.15 / $51.53	Professional		$13.15	$13.15	$51.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.85 / $51.53 / $67.52	Facility		$38.85	$51.53	$67.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.15 / $13.15 / $16.25	Facility	26	$13.15	$13.15	$16.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $38.38 / $38.38 / $47.45	Facility	TC	$38.38	$38.38	$47.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.60 / $43.66 / $70.61	Professional		$29.60	$43.66	$70.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $12.64 / $20.59	Professional	26	$8.39	$12.64	$20.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.18 / $30.85 / $49.17	Professional	TC	$21.18	$30.85	$49.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.51 / $47.79 / $67.52	Facility		$32.51	$47.79	$67.52
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.15 / $13.15 / $16.25	Facility	26	$13.15	$13.15	$16.25
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $38.38 / $38.38 / $47.45	Facility	TC	$38.38	$38.38	$47.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $51.53 / $82.12	Professional		$31.68	$51.53	$82.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.15 / $17.20	Professional	26	$8.32	$13.15	$17.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.99 / $32.24 / $43.24	Professional	TC	$20.99	$32.24	$43.24
United Facility/Professional Professional Modifier Low / Median / High Price $28.29 / $31.76 / $55.78	Professional		$28.29	$31.76	$55.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $9.02 / $15.84	Professional	26	$8.85	$9.02	$15.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $22.74 / $39.94	Professional	TC	$19.54	$22.74	$39.94