Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.64 / $228.00 / $591.00	Facility		$35.64	$228.00	$591.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $231.08 / $245.74 / $365.69	Facility	TC	$231.08	$245.74	$365.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.15 / $37.06 / $141.22	Professional		$12.15	$37.06	$141.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $9.25 / $42.93	Professional	26	$7.72	$9.25	$42.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.10 / $208.50 / $208.50	Professional	50	$17.10	$208.50	$208.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.05 / $17.55 / $96.53	Professional	52	$14.05	$17.55	$96.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $24.25 / $105.75	Professional	TC	$19.46	$24.25	$105.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.86 / $77,999.99 / $94,999.99	Facility		$213.86	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $12.62 / $54.16	Professional		$12.62	$12.62	$54.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.13 / $54.16 / $74.97	Facility		$43.13	$54.16	$74.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.62 / $12.62 / $15.60	Facility	26	$12.62	$12.62	$15.60
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.54 / $41.54 / $51.35	Facility	TC	$41.54	$41.54	$51.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $45.59 / $74.58	Professional		$29.41	$45.59	$74.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $12.62 / $19.75	Professional	26	$8.39	$12.62	$19.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $31.53 / $54.04	Professional	TC	$20.59	$31.53	$54.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.13 / $50.94 / $74.97	Facility		$34.13	$50.94	$74.97
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.62 / $12.62 / $15.60	Facility	26	$12.62	$12.62	$15.60
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $41.54 / $41.54 / $51.35	Facility	TC	$41.54	$41.54	$51.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.35 / $54.16 / $86.31	Professional		$33.35	$54.16	$86.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.35 / $18.96	Professional	26	$8.32	$13.35	$18.96
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $37.52 / $45.98	Professional	TC	$19.19	$37.52	$45.98
United Facility/Professional Professional Modifier Low / Median / High Price $28.76 / $33.92 / $59.57	Professional		$28.76	$33.92	$59.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $9.22 / $15.21	Professional	26	$8.59	$9.22	$15.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $25.26 / $44.36	Professional	TC	$19.54	$25.26	$44.36