Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $303.70 / $327.86 / $628.22	Facility	TC	$303.70	$327.86	$628.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.44 / $51.00 / $209.70	Professional		$21.44	$51.00	$209.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.51 / $18.89 / $49.78	Professional	26	$10.51	$18.89	$49.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $155.52 / $253.14 / $414.00	Professional	50	$155.52	$253.14	$414.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.02 / $24.46 / $126.57	Professional	52	$19.02	$24.46	$126.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $36.86 / $146.00	Professional	TC	$27.87	$36.86	$146.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $17.35 / $74.66	Professional		$17.35	$17.35	$74.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.35 / $17.35 / $21.45	Facility	26	$17.35	$17.35	$21.45
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $57.31 / $57.31 / $70.84	Facility	TC	$57.31	$57.31	$70.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $62.67 / $96.22	Professional		$37.11	$62.67	$96.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.70 / $17.35 / $26.30	Professional	26	$10.70	$17.35	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.31 / $45.05 / $68.65	Professional	TC	$26.31	$45.05	$68.65
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.35 / $17.35 / $21.45	Facility	26	$17.35	$17.35	$21.45
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $57.31 / $57.31 / $70.84	Facility	TC	$57.31	$57.31	$70.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.08 / $74.41 / $117.32	Professional		$46.08	$74.41	$117.32
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $17.35 / $24.19	Professional	26	$10.36	$17.35	$24.19
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $25.83 / $46.90 / $67.91	Professional	TC	$25.83	$46.90	$67.91
United Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $44.39 / $77.95	Professional		$39.38	$44.39	$77.95
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 $28.02 / $32.84 / $57.67	Professional	TC	$28.02	$32.84	$57.67