Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.88 / $221.35 / $394.20	Facility		$70.88	$221.35	$394.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.44 / $31.44 / $31.44	Facility	26	$31.44	$31.44	$31.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $160.55 / $245.74 / $245.74	Facility	TC	$160.55	$245.74	$245.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.27 / $32.09 / $137.13	Professional		$17.27	$32.09	$137.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.73 / $42.00	Professional	26	$7.03	$8.73	$42.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $22.70 / $60.15	Professional	TC	$18.21	$22.70	$60.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $163.69 / $77,999.99 / $94,999.99	Facility		$163.69	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.09 / $12.09 / $46.27	Professional		$12.09	$12.09	$46.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $46.27 / $61.11	Facility		$35.15	$46.27	$61.11
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 $34.18 / $34.18 / $42.25	Facility	TC	$34.18	$34.18	$42.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.87 / $41.65 / $64.84	Professional		$26.87	$41.65	$64.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $12.09 / $19.75	Professional	26	$7.61	$12.09	$19.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $27.94 / $44.30	Professional	TC	$19.21	$27.94	$44.30
Providence Facility/Professional Facility Modifier Low / Median / High Price $29.17 / $43.07 / $61.11	Facility		$29.17	$43.07	$61.11
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 $34.18 / $34.18 / $42.25	Facility	TC	$34.18	$34.18	$42.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.40 / $46.27 / $73.73	Professional		$28.40	$46.27	$73.73
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $12.09 / $16.52	Professional	26	$7.58	$12.09	$16.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.84 / $28.72 / $41.87	Professional	TC	$18.84	$28.72	$41.87
United Facility/Professional Professional Modifier Low / Median / High Price $25.78 / $29.23 / $51.33	Professional		$25.78	$29.23	$51.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $8.66 / $15.21	Professional	26	$8.11	$8.66	$15.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $20.57 / $36.11	Professional	TC	$18.80	$20.57	$36.11