Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.00 / $218.40 / $332.09	Facility		$81.00	$218.40	$332.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $144.21 / $245.74 / $296.39	Facility	TC	$144.21	$245.74	$296.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $35.10 / $135.40	Professional		$17.98	$35.10	$135.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.68 / $36.96	Professional	26	$7.33	$8.68	$36.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $22.96 / $98.02	Professional	TC	$17.57	$22.96	$98.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.44 / $77,999.99 / $94,999.99	Facility		$190.44	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.09 / $12.09 / $49.95	Professional		$12.09	$12.09	$49.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $49.95 / $64.56	Facility		$37.15	$49.95	$64.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $12.09 / $14.95	Facility	26	$12.09	$12.09	$14.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $37.86 / $37.86 / $46.80	Facility	TC	$37.86	$37.86	$46.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.63 / $41.16 / $68.09	Professional		$27.63	$41.16	$68.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $12.09 / $19.01	Professional	26	$8.39	$12.09	$19.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $28.52 / $48.36	Professional	TC	$19.21	$28.52	$48.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $31.49 / $44.79 / $64.56	Facility		$31.49	$44.79	$64.56
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $12.09 / $14.95	Facility	26	$12.09	$12.09	$14.95
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $37.86 / $37.86 / $46.80	Facility	TC	$37.86	$37.86	$46.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.71 / $49.95 / $79.61	Professional		$30.71	$49.95	$79.61
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.37 / $17.20	Professional	26	$8.32	$12.37	$17.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $33.40 / $41.54	Professional	TC	$18.48	$33.40	$41.54
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $31.04 / $54.51	Professional		$26.92	$31.04	$54.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $8.85 / $14.58	Professional	26	$8.30	$8.85	$14.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.07 / $22.74 / $39.93	Professional	TC	$18.07	$22.74	$39.93