Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.34 / $193.11 / $456.00	Facility		$48.34	$193.11	$456.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.30 / $8.30 / $49.40	Facility	26	$8.30	$8.30	$49.40
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $209.38 / $279.30 / $626.14	Facility	TC	$209.38	$279.30	$626.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.87 / $41.00 / $140.00	Professional		$14.87	$41.00	$140.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.88 / $41.00	Professional	26	$7.33	$10.88	$41.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.24 / $38.74 / $307.37	Professional	50	$30.24	$38.74	$307.37
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.20 / $17.57 / $94.40	Professional	52	$14.20	$17.57	$94.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $29.38 / $112.00	Professional	TC	$21.32	$29.38	$112.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $197.16 / $77,999.99 / $94,999.99	Facility		$197.16	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.62 / $12.62 / $54.16	Professional		$12.62	$12.62	$54.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.91 / $54.16 / $72.84	Facility		$41.91	$54.16	$72.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.62 / $12.62 / $15.60	Facility	26	$12.62	$12.62	$15.60
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.54 / $41.54 / $51.35	Facility	TC	$41.54	$41.54	$51.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.81 / $42.04 / $72.23	Professional		$27.81	$42.04	$72.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $12.62 / $19.85	Professional	26	$8.39	$12.62	$19.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.50 / $33.17 / $51.60	Professional	TC	$20.50	$33.17	$51.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $34.17 / $50.53 / $72.84	Facility		$34.17	$50.53	$72.84
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.62 / $12.62 / $15.60	Facility	26	$12.62	$12.62	$15.60
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $41.54 / $41.54 / $51.35	Facility	TC	$41.54	$41.54	$51.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $54.16 / $86.31	Professional		$33.33	$54.16	$86.31
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.62 / $16.52	Professional	26	$8.32	$12.62	$16.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $34.59 / $49.41	Professional	TC	$20.30	$34.59	$49.41
United Facility/Professional Professional Modifier Low / Median / High Price $30.60 / $33.20 / $58.88	Professional		$30.60	$33.20	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $8.85 / $15.36	Professional	26	$8.59	$8.85	$15.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $24.54 / $43.10	Professional	TC	$21.75	$24.54	$43.10