Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.62 / $249.83 / $761.00	Professional		$149.62	$249.83	$761.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.29 / $60.32 / $234.00	Professional	26	$53.29	$60.32	$234.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.92 / $195.40 / $214.94	Professional	TC	$89.92	$195.40	$214.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.81 / $87.81 / $220.84	Professional		$87.81	$87.81	$220.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.81 / $87.81 / $108.55	Facility	26	$87.81	$87.81	$108.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.93 / $269.08 / $366.46	Professional		$195.93	$269.08	$366.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.98 / $87.81 / $139.40	Professional	26	$56.98	$87.81	$139.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.17 / $186.49 / $255.99	Professional	TC	$124.17	$186.49	$255.99
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $87.81 / $87.81 / $108.55	Facility	26	$87.81	$87.81	$108.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.49 / $229.16 / $363.05	Professional		$137.49	$229.16	$363.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $57.17 / $87.81 / $116.30	Professional	26	$57.17	$87.81	$116.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $116.77 / $146.08 / $212.61	Professional	TC	$116.77	$146.08	$212.61
United Facility/Professional Professional Modifier Low / Median / High Price $128.84 / $197.61 / $266.20	Professional		$128.84	$197.61	$266.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.74 / $52.34 / $107.11	Professional	26	$51.74	$52.34	$107.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.00 / $133.03 / $191.97	Professional	TC	$77.00	$133.03	$191.97