Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $161.99 / $242.32 / $242.32	Facility	TC	$161.99	$242.32	$242.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.88 / $42.62 / $164.47	Professional		$26.88	$42.62	$164.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.08 / $10.37 / $32.00	Professional	26	$6.08	$10.37	$32.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.39 / $19.78 / $102.92	Professional	52	$15.39	$19.78	$102.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $32.61 / $87.18	Professional	TC	$22.57	$32.61	$87.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $10.52 / $60.47	Professional		$10.52	$10.52	$60.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.52 / $10.52 / $13.00	Facility	26	$10.52	$10.52	$13.00
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $49.95 / $49.95 / $61.75	Facility	TC	$49.95	$49.95	$61.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.61 / $46.63 / $77.56	Professional		$25.61	$46.63	$77.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $10.10 / $16.48	Professional	26	$6.45	$10.10	$16.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $36.54 / $60.53	Professional	TC	$19.32	$36.54	$60.53
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.52 / $10.52 / $13.00	Facility	26	$10.52	$10.52	$13.00
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $49.95 / $49.95 / $61.75	Facility	TC	$49.95	$49.95	$61.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $37.40 / $60.39 / $95.53	Professional		$37.40	$60.39	$95.53
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.15 / $10.52 / $13.78	Professional	26	$6.15	$10.52	$13.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $41.62 / $56.94	Professional	TC	$19.55	$41.62	$56.94
United Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $36.09 / $63.38	Professional		$29.13	$36.09	$63.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $7.22 / $12.68	Professional	26	$7.01	$7.22	$12.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.12 / $28.87 / $50.70	Professional	TC	$22.12	$28.87	$50.70