Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.28 / $174.13 / $333.05	Facility		$17.28	$174.13	$333.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.04 / $24.04 / $24.04	Facility	26	$24.04	$24.04	$24.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $154.80 / $238.22 / $238.22	Facility	TC	$154.80	$238.22	$238.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.62 / $30.77 / $155.49	Professional		$24.62	$30.77	$155.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $7.83 / $37.00	Professional	26	$6.71	$7.83	$37.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $32.40 / $32.40 / $76.58	Professional	50	$32.40	$32.40	$76.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.59 / $15.70 / $159.60	Professional	52	$11.59	$15.70	$159.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $20.28 / $39.60	Professional	TC	$17.89	$20.28	$39.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.74 / $77,999.99 / $94,999.99	Facility		$173.74	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.57 / $11.57 / $45.22	Professional		$11.57	$11.57	$45.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $45.22 / $60.05	Facility		$34.54	$45.22	$60.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.57 / $11.57 / $14.30	Facility	26	$11.57	$11.57	$14.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.65 / $33.65 / $41.60	Facility	TC	$33.65	$33.65	$41.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.22 / $35.61 / $62.41	Professional		$25.22	$35.61	$62.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.61 / $11.57 / $18.27	Professional	26	$7.61	$11.57	$18.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $29.02 / $43.49	Professional	TC	$18.48	$29.02	$43.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.17 / $41.89 / $60.05	Facility		$28.17	$41.89	$60.05
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.57 / $11.57 / $14.30	Facility	26	$11.57	$11.57	$14.30
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $33.65 / $33.65 / $41.60	Facility	TC	$33.65	$33.65	$41.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $45.22 / $71.23	Professional		$27.74	$45.22	$71.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $11.57 / $15.15	Professional	26	$7.58	$11.57	$15.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.13 / $30.48 / $42.55	Professional	TC	$18.13	$30.48	$42.55
United Facility/Professional Professional Modifier Low / Median / High Price $26.14 / $28.15 / $49.44	Professional		$26.14	$28.15	$49.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.88 / $8.11 / $13.95	Professional	26	$7.88	$8.11	$13.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.07 / $20.21 / $35.49	Professional	TC	$18.07	$20.21	$35.49