Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.40 / $238.22 / $689.76	Facility		$95.40	$238.22	$689.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.50 / $27.34 / $68.38	Facility	26	$18.50	$27.34	$68.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $92.73 / $238.22 / $327.49	Facility	TC	$92.73	$238.22	$327.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.44 / $44.31 / $183.38	Professional		$16.44	$44.31	$183.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $12.99 / $38.92	Professional	26	$8.08	$12.99	$38.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.85 / $17.85 / $299.48	Professional	50	$17.85	$17.85	$299.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $36.04 / $132.00	Professional	TC	$25.37	$36.04	$132.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $247.27 / $77,999.99 / $94,999.99	Facility		$247.27	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $13.15 / $65.20	Professional		$13.15	$13.15	$65.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.71 / $65.20 / $89.89	Facility		$51.71	$65.20	$89.89
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 $52.05 / $52.05 / $64.34	Facility	TC	$52.05	$52.05	$64.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.64 / $49.95 / $84.41	Professional		$30.64	$49.95	$84.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $13.14 / $20.59	Professional	26	$8.39	$13.14	$20.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $41.04 / $62.97	Professional	TC	$22.74	$41.04	$62.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.79 / $60.45 / $89.89	Facility		$40.79	$60.45	$89.89
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 $52.05 / $52.05 / $64.34	Facility	TC	$52.05	$52.05	$64.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.27 / $65.20 / $103.07	Professional		$40.27	$65.20	$103.07
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 $23.42 / $43.38 / $61.74	Professional	TC	$23.42	$43.38	$61.74
United Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $39.34 / $113.77	Professional		$34.29	$39.34	$113.77
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 $25.44 / $30.32 / $53.25	Professional	TC	$25.44	$30.32	$53.25