Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.18 / $233.00 / $398.05	Facility		$84.18	$233.00	$398.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.50 / $29.50 / $29.50	Facility	26	$29.50	$29.50	$29.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $228.14 / $245.74 / $378.06	Facility	TC	$228.14	$245.74	$378.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.34 / $46.64 / $187.69	Professional		$17.34	$46.64	$187.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $10.31 / $46.00	Professional	26	$8.56	$10.31	$46.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $34.00 / $249.00	Professional	50	$19.27	$34.00	$249.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.80 / $21.01 / $113.15	Professional	52	$16.80	$21.01	$113.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $30.45 / $153.41	Professional	TC	$24.44	$30.45	$153.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $247.27 / $77,999.99 / $94,999.99	Facility		$247.27	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.20 / $14.20 / $64.67	Professional		$14.20	$14.20	$64.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.10 / $64.67 / $88.83	Facility		$51.10	$64.67	$88.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.20 / $14.20 / $17.55	Facility	26	$14.20	$14.20	$17.55
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $50.48 / $50.48 / $62.40	Facility	TC	$50.48	$50.48	$62.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.13 / $54.62 / $86.12	Professional		$33.13	$54.62	$86.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $14.20 / $22.18	Professional	26	$8.77	$14.20	$22.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.47 / $39.54 / $62.97	Professional	TC	$23.47	$39.54	$62.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $40.49 / $60.45 / $88.83	Facility		$40.49	$60.45	$88.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.20 / $14.20 / $17.55	Facility	26	$14.20	$14.20	$17.55
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $50.48 / $50.48 / $62.40	Facility	TC	$50.48	$50.48	$62.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.92 / $64.67 / $102.24	Professional		$39.92	$64.67	$102.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.20 / $20.07	Professional	26	$8.71	$14.20	$20.07
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.71 / $43.38 / $59.00	Professional	TC	$22.71	$43.38	$59.00
United Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $39.70 / $69.72	Professional		$34.29	$39.70	$69.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $9.96 / $17.11	Professional	26	$9.67	$9.96	$17.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.33 / $29.96 / $53.13	Professional	TC	$24.33	$29.96	$53.13