Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.85 / $225.30 / $361.96	Facility		$168.85	$225.30	$361.96
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $231.08 / $231.08 / $388.24	Facility	TC	$231.08	$231.08	$388.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $31.31 / $170.00	Professional		$16.20	$31.31	$170.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.68 / $36.00	Professional	26	$7.03	$8.68	$36.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.23 / $16.53 / $47.96	Professional	52	$13.23	$16.53	$47.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $21.10 / $42.04	Professional	TC	$18.53	$21.10	$42.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.47 / $77,999.99 / $94,999.99	Facility		$200.47	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.09 / $12.09 / $51.00	Professional		$12.09	$12.09	$51.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.07 / $51.00 / $69.65	Facility		$40.07	$51.00	$69.65
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 $38.90 / $38.90 / $48.10	Facility	TC	$38.90	$38.90	$48.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $42.15 / $71.34	Professional		$27.73	$42.15	$71.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $12.09 / $19.75	Professional	26	$7.61	$12.09	$19.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $30.02 / $50.79	Professional	TC	$19.43	$30.02	$50.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $32.49 / $47.55 / $69.65	Facility		$32.49	$47.55	$69.65
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 $38.90 / $38.90 / $48.10	Facility	TC	$38.90	$38.90	$48.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.37 / $51.00 / $82.12	Professional		$31.37	$51.00	$82.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $12.09 / $16.52	Professional	26	$7.58	$12.09	$16.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $35.17 / $43.92	Professional	TC	$18.48	$35.17	$43.92
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $32.11 / $56.41	Professional		$26.92	$32.11	$56.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $8.66 / $22.19	Professional	26	$8.11	$8.66	$22.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $23.46 / $41.60	Professional	TC	$18.80	$23.46	$41.60