Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.35 / $145.35 / $145.35	Facility	26	$145.35	$145.35	$145.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.00 / $475.00 / $1,325.96	Professional		$196.00	$475.00	$1,325.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.42 / $140.00 / $341.31	Professional	26	$65.42	$140.00	$341.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $920.52 / $920.52 / $920.52	Professional	50	$920.52	$920.52	$920.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $104.19 / $187.50 / $662.98	Professional	52	$104.19	$187.50	$662.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.29 / $335.00 / $726.70	Professional	TC	$154.29	$335.00	$726.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.43 / $100.43 / $328.63	Professional		$100.43	$100.43	$328.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.43 / $100.43 / $124.15	Facility	26	$100.43	$100.43	$124.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.01 / $493.75 / $605.32	Professional		$326.01	$493.75	$605.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $100.43 / $158.09	Professional	26	$64.39	$100.43	$158.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.70 / $335.90 / $523.83	Professional	TC	$216.70	$335.90	$523.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $100.43 / $100.43 / $124.15	Facility	26	$100.43	$100.43	$124.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $213.87 / $341.31 / $541.55	Professional		$213.87	$341.31	$541.55
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $64.39 / $100.43 / $135.01	Professional	26	$64.39	$100.43	$135.01
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $216.70 / $271.20 / $436.10	Professional	TC	$216.70	$271.20	$436.10
United Facility/Professional Professional Modifier Low / Median / High Price $197.56 / $352.45 / $417.79	Professional		$197.56	$352.45	$417.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.90 / $59.55 / $121.69	Professional	26	$58.90	$59.55	$121.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $262.16 / $406.09	Professional	TC	$138.66	$262.16	$406.09