Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.53 / $227.09 / $656.63	Facility		$37.53	$227.09	$656.63
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $202.92 / $245.74 / $266.86	Facility	TC	$202.92	$245.74	$266.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.07 / $32.42 / $123.00	Professional		$19.07	$32.42	$123.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $8.52 / $37.54	Professional	26	$7.56	$8.52	$37.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $22.42 / $44.10	Professional	TC	$18.82	$22.42	$44.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.80 / $77,999.99 / $94,999.99	Facility		$193.80	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.09 / $12.09 / $50.48	Professional		$12.09	$12.09	$50.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.46 / $50.48 / $68.59	Facility		$39.46	$50.48	$68.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $12.09 / $14.95	Facility	26	$12.09	$12.09	$14.95
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 / $43.65 / $69.70	Professional		$29.60	$43.65	$69.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $12.09 / $19.75	Professional	26	$8.39	$12.09	$19.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.18 / $28.52 / $49.17	Professional	TC	$21.18	$28.52	$49.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.15 / $47.79 / $68.59	Facility		$32.15	$47.79	$68.59
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $12.09 / $14.95	Facility	26	$12.09	$12.09	$14.95
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 $31.04 / $50.48 / $81.29	Professional		$31.04	$50.48	$81.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.86 / $17.20	Professional	26	$8.32	$12.86	$17.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.63 / $34.00 / $43.24	Professional	TC	$20.63	$34.00	$43.24
United Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $31.76 / $55.78	Professional		$28.39	$31.76	$55.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $8.85 / $15.21	Professional	26	$8.59	$8.85	$15.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $23.10 / $40.57	Professional	TC	$19.54	$23.10	$40.57