Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.53 / $228.95 / $457.84	Facility		$37.53	$228.95	$457.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $223.35 / $233.65 / $381.21	Facility	TC	$223.35	$233.65	$381.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $36.40 / $145.00	Professional		$18.00	$36.40	$145.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.52 / $37.00	Professional	26	$7.33	$9.52	$37.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.14 / $79.14 / $79.14	Professional	50	$79.14	$79.14	$79.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $27.99 / $80.20	Professional	TC	$23.51	$27.99	$80.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.86 / $77,999.99 / $94,999.99	Facility		$213.86	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $13.15 / $52.05	Professional		$13.15	$13.15	$52.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.22 / $52.05 / $66.45	Facility		$38.22	$52.05	$66.45
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 $38.90 / $38.90 / $48.10	Facility	TC	$38.90	$38.90	$48.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $50.68 / $68.98	Professional		$32.15	$50.68	$68.98
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 $23.05 / $36.08 / $47.55	Professional	TC	$23.05	$36.08	$47.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.51 / $50.74 / $71.22	Facility		$32.51	$50.74	$71.22
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 $38.90 / $38.90 / $48.10	Facility	TC	$38.90	$38.90	$48.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $52.05 / $82.12	Professional		$32.00	$52.05	$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 $23.02 / $37.52 / $52.83	Professional	TC	$23.02	$37.52	$52.83
United Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $33.92 / $55.14	Professional		$31.40	$33.92	$55.14
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 $22.38 / $25.07 / $39.29	Professional	TC	$22.38	$25.07	$39.29