Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.28 / $130.93 / $294.50	Facility		$44.28	$130.93	$294.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $111.55 / $186.80 / $197.03	Facility	TC	$111.55	$186.80	$197.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $37.00 / $156.00	Professional		$27.73	$37.00	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.05 / $38.09	Professional	26	$7.66	$9.05	$38.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.00 / $18.00 / $36.00	Professional	50	$18.00	$18.00	$36.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.91 / $17.39 / $94.43	Professional	52	$13.91	$17.39	$94.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $24.85 / $95.40	Professional	TC	$20.07	$24.85	$95.40
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 $12.62 / $12.62 / $53.63	Professional		$12.62	$12.62	$53.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.91 / $53.63 / $72.84	Facility		$41.91	$53.63	$72.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.62 / $12.62 / $15.60	Facility	26	$12.62	$12.62	$15.60
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 $26.77 / $42.06 / $73.77	Professional		$26.77	$42.06	$73.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $12.62 / $19.75	Professional	26	$7.61	$12.62	$19.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $32.53 / $53.23	Professional	TC	$19.43	$32.53	$53.23
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.79 / $49.92 / $72.84	Facility		$33.79	$49.92	$72.84
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.62 / $12.62 / $15.60	Facility	26	$12.62	$12.62	$15.60
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 $33.02 / $53.63 / $85.48	Professional		$33.02	$53.63	$85.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $12.62 / $18.71	Professional	26	$7.64	$12.62	$18.71
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.86 / $37.52 / $48.72	Professional	TC	$18.86	$37.52	$48.72
United Facility/Professional Professional Modifier Low / Median / High Price $29.00 / $33.20 / $58.31	Professional		$29.00	$33.20	$58.31
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 $20.28 / $24.54 / $43.10	Professional	TC	$20.28	$24.54	$43.10