Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.48 / $269.06 / $680.94	Facility		$92.48	$269.06	$680.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $193.80 / $193.80 / $193.80	Facility	26	$193.80	$193.80	$193.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $205.87 / $245.74 / $313.07	Facility	TC	$205.87	$245.74	$313.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.69 / $39.24 / $134.00	Professional		$9.69	$39.24	$134.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $10.16 / $43.00	Professional	26	$8.56	$10.16	$43.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.86 / $19.27 / $33.27	Professional	50	$17.86	$19.27	$33.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $28.27 / $104.00	Professional	TC	$19.14	$28.27	$104.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $77,999.99 / $94,999.99	Facility		$187.13	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.20 / $14.20 / $55.21	Professional		$14.20	$14.20	$55.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.68 / $55.21 / $70.70	Facility		$40.68	$55.21	$70.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.20 / $14.20 / $17.55	Facility	26	$14.20	$14.20	$17.55
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.01 / $41.01 / $50.70	Facility	TC	$41.01	$41.01	$50.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.99 / $42.49 / $71.45	Professional		$27.99	$42.49	$71.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $14.20 / $22.18	Professional	26	$8.77	$14.20	$22.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $30.85 / $49.27	Professional	TC	$20.72	$30.85	$49.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.53 / $49.06 / $70.70	Facility		$34.53	$49.06	$70.70
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.20 / $14.20 / $17.55	Facility	26	$14.20	$14.20	$17.55
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $41.01 / $41.01 / $50.70	Facility	TC	$41.01	$41.01	$50.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $55.21 / $87.15	Professional		$33.97	$55.21	$87.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.20 / $20.07	Professional	26	$8.71	$14.20	$20.07
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.63 / $32.83 / $45.01	Professional	TC	$20.63	$32.83	$45.01
United Facility/Professional Professional Modifier Low / Median / High Price $29.32 / $33.56 / $58.94	Professional		$29.32	$33.56	$58.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $9.96 / $17.27	Professional	26	$9.67	$9.96	$17.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $23.82 / $41.83	Professional	TC	$19.54	$23.82	$41.83