Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.61 / $243.40 / $696.16	Facility		$82.61	$243.40	$696.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.50 / $18.50 / $34.19	Facility	26	$18.50	$18.50	$34.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $82.61 / $211.85 / $269.66	Facility	TC	$82.61	$211.85	$269.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $40.00 / $145.00	Professional		$15.00	$40.00	$145.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $11.20 / $41.36	Professional	26	$7.78	$11.20	$41.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.52 / $57.92 / $114.57	Professional	50	$16.52	$57.92	$114.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $34.27 / $140.00	Professional	TC	$22.91	$34.27	$140.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $217.17 / $77,999.99 / $94,999.99	Facility		$217.17	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $13.15 / $58.89	Professional		$13.15	$13.15	$58.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.98 / $58.89 / $78.19	Facility		$44.98	$58.89	$78.19
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 $45.74 / $45.74 / $56.55	Facility	TC	$45.74	$45.74	$56.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $47.67 / $77.11	Professional		$29.46	$47.67	$77.11
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 $20.79 / $34.92 / $55.66	Professional	TC	$20.79	$34.92	$55.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.82 / $53.58 / $78.19	Facility		$36.82	$53.58	$78.19
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 $45.74 / $45.74 / $56.55	Facility	TC	$45.74	$45.74	$56.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $58.77 / $93.02	Professional		$36.31	$58.77	$93.02
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 $20.57 / $38.10 / $50.78	Professional	TC	$20.57	$38.10	$50.78
United Facility/Professional Professional Modifier Low / Median / High Price $30.60 / $35.36 / $102.66	Professional		$30.60	$35.36	$102.66
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 $21.75 / $26.35 / $46.28	Professional	TC	$21.75	$26.35	$46.28