Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $209.89 / $209.89 / $209.89	Facility	26	$209.89	$209.89	$209.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.60 / $475.00 / $1,189.00	Professional		$207.60	$475.00	$1,189.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.63 / $140.00 / $329.04	Professional	26	$68.63	$140.00	$329.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $104.35 / $187.50 / $665.13	Professional	52	$104.35	$187.50	$665.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.29 / $335.00 / $565.00	Professional	TC	$154.29	$335.00	$565.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.43 / $100.43 / $329.15	Professional		$100.43	$100.43	$329.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.43 / $100.43 / $124.15	Facility	26	$100.43	$100.43	$124.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.50 / $494.54 / $607.79	Professional		$326.50	$494.54	$607.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $100.43 / $160.94	Professional	26	$64.39	$100.43	$160.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.72 / $343.65 / $520.75	Professional	TC	$228.72	$343.65	$520.75
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $100.43 / $100.43 / $124.15	Facility	26	$100.43	$100.43	$124.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $214.20 / $341.85 / $542.42	Professional		$214.20	$341.85	$542.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $100.43 / $135.01	Professional	26	$64.39	$100.43	$135.01
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $216.70 / $271.20 / $433.82	Professional	TC	$216.70	$271.20	$433.82
United Facility/Professional Professional Modifier Low / Median / High Price $198.48 / $351.92 / $414.08	Professional		$198.48	$351.92	$414.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.04 / $59.82 / $123.58	Professional	26	$59.04	$59.82	$123.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $262.17 / $406.09	Professional	TC	$138.66	$262.17	$406.09