Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.99 / $339.97 / $1,167.11	Professional		$250.99	$339.97	$1,167.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.78 / $64.54 / $260.00	Professional	26	$56.78	$64.54	$260.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.85 / $281.72 / $436.02	Professional	TC	$186.85	$281.72	$436.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $94.12 / $377.52	Professional		$94.12	$94.12	$377.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.12 / $94.12 / $116.35	Facility	26	$94.12	$94.12	$116.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.98 / $377.52 / $567.22	Professional		$300.98	$377.52	$567.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $94.12 / $149.12	Professional	26	$61.32	$94.12	$149.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.24 / $283.41 / $425.81	Professional	TC	$216.24	$283.41	$425.81
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $94.12 / $94.12 / $116.35	Facility	26	$94.12	$94.12	$116.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $240.04 / $377.52 / $613.41	Professional		$240.04	$377.52	$613.41
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $94.12 / $124.52	Professional	26	$61.32	$94.12	$124.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $216.24 / $283.33 / $425.81	Professional	TC	$216.24	$283.33	$425.81
United Facility/Professional Professional Modifier Low / Median / High Price $213.50 / $280.51 / $441.12	Professional		$213.50	$280.51	$441.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.39 / $55.79 / $114.72	Professional	26	$55.39	$55.79	$114.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.52 / $224.72 / $326.39	Professional	TC	$151.52	$224.72	$326.39