Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $451.63 / $451.63 / $451.63	Facility	TC	$451.63	$451.63	$451.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $51.88 / $269.00	Professional		$44.27	$51.88	$269.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.41 / $14.65 / $33.97	Professional	26	$13.41	$14.65	$33.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $35.79 / $82.09	Professional	TC	$30.85	$35.79	$82.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.08 / $22.08 / $85.18	Professional		$22.08	$22.08	$85.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.08 / $22.08 / $27.30	Facility	26	$22.08	$22.08	$27.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $63.10 / $63.10 / $78.00	Facility	TC	$63.10	$63.10	$78.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.64 / $66.93 / $115.97	Professional		$49.64	$66.93	$115.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $20.19 / $34.43	Professional	26	$16.26	$20.19	$34.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.39 / $47.06 / $79.20	Professional	TC	$33.39	$47.06	$79.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $22.08 / $22.08 / $27.30	Facility	26	$22.08	$22.08	$27.30
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $63.10 / $63.10 / $78.00	Facility	TC	$63.10	$63.10	$78.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $52.51 / $85.18 / $134.91	Professional		$52.51	$85.18	$134.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $16.26 / $22.08 / $29.61	Professional	26	$16.26	$22.08	$29.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.39 / $59.03 / $69.23	Professional	TC	$33.39	$59.03	$69.23
United Facility/Professional Professional Modifier Low / Median / High Price $49.05 / $52.69 / $93.44	Professional		$49.05	$52.69	$93.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $15.86 / $26.62	Professional	26	$15.16	$15.86	$26.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.65 / $37.53 / $65.91	Professional	TC	$33.65	$37.53	$65.91