Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.28 / $204.00 / $494.84	Facility		$44.28	$204.00	$494.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $137.47 / $393.36 / $393.36	Facility	TC	$137.47	$393.36	$393.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $34.72 / $191.70	Professional		$24.92	$34.72	$191.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.56 / $47.79	Professional	26	$7.03	$8.56	$47.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $7.98 / $36.00 / $36.00	Professional	50	$7.98	$36.00	$36.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.82 / $17.37 / $174.20	Professional	52	$12.82	$17.37	$174.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $22.31 / $84.60	Professional	TC	$17.89	$22.31	$84.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $77,999.99 / $94,999.99	Facility		$187.13	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $12.62 / $49.95	Professional		$12.62	$12.62	$49.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.60 / $49.95 / $65.36	Facility		$37.60	$49.95	$65.36
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 $37.33 / $37.33 / $46.15	Facility	TC	$37.33	$37.33	$46.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.13 / $41.15 / $67.28	Professional		$26.13	$41.15	$67.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $12.13 / $19.75	Professional	26	$7.61	$12.13	$19.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $28.52 / $46.73	Professional	TC	$18.48	$28.52	$46.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.16 / $45.35 / $65.36	Facility		$31.16	$45.35	$65.36
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 $37.33 / $37.33 / $46.15	Facility	TC	$37.33	$37.33	$46.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.71 / $49.95 / $78.77	Professional		$30.71	$49.95	$78.77
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $12.62 / $16.52	Professional	26	$7.58	$12.62	$16.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $32.83 / $41.18	Professional	TC	$18.48	$32.83	$41.18
United Facility/Professional Professional Modifier Low / Median / High Price $26.14 / $30.68 / $53.88	Professional		$26.14	$30.68	$53.88
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 $17.55 / $22.02 / $37.74	Professional	TC	$17.55	$22.02	$37.74