Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.33 / $227.74 / $381.61	Facility		$75.33	$227.74	$381.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.62 / $11.62 / $34.99	Facility	26	$11.62	$11.62	$34.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $223.35 / $245.74 / $327.75	Facility	TC	$223.35	$245.74	$327.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.10 / $49.65 / $176.80	Professional		$11.10	$49.65	$176.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $12.02 / $49.50	Professional	26	$10.02	$12.02	$49.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $38.11 / $132.80	Professional	TC	$27.55	$38.11	$132.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $284.02 / $77,999.99 / $94,999.99	Facility		$284.02	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $16.82 / $75.19	Professional		$16.82	$16.82	$75.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.46 / $75.19 / $101.62	Facility		$58.46	$75.19	$101.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.82 / $16.82 / $20.80	Facility	26	$16.82	$16.82	$20.80
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $58.36 / $58.36 / $72.15	Facility	TC	$58.36	$58.36	$72.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $54.12 / $99.47	Professional		$37.65	$54.12	$99.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.11 / $14.98 / $26.30	Professional	26	$12.11	$14.98	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $42.05 / $71.90	Professional	TC	$29.84	$42.05	$71.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.82 / $69.64 / $101.62	Facility		$44.82	$69.64	$101.62
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.82 / $16.82 / $20.80	Facility	26	$16.82	$16.82	$20.80
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $58.36 / $58.36 / $72.15	Facility	TC	$58.36	$58.36	$72.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.41 / $75.19 / $118.16	Professional		$46.41	$75.19	$118.16
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.11 / $16.82 / $22.00	Professional	26	$12.11	$16.82	$22.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $52.80 / $64.05	Professional	TC	$29.84	$52.80	$64.05
United Facility/Professional Professional Modifier Low / Median / High Price $41.53 / $45.83 / $130.41	Professional		$41.53	$45.83	$130.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $11.80 / $20.29	Professional	26	$11.46	$11.80	$20.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.07 / $34.28 / $60.20	Professional	TC	$30.07	$34.28	$60.20