Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.77 / $410.67 / $1,387.00	Professional		$267.77	$410.67	$1,387.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.45 / $71.06 / $191.61	Professional	26	$62.45	$71.06	$191.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.20 / $346.55 / $640.65	Professional	TC	$187.20	$346.55	$640.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.06 / $103.06 / $424.32	Professional		$103.06	$103.06	$424.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.06 / $103.06 / $127.40	Facility	26	$103.06	$103.06	$127.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $340.05 / $435.55 / $654.16	Professional		$340.05	$435.55	$654.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $103.06 / $164.43	Professional	26	$67.01	$103.06	$164.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $265.16 / $338.85 / $550.04	Professional	TC	$265.16	$338.85	$550.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $103.06 / $103.06 / $127.40	Facility	26	$103.06	$103.06	$127.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $268.83 / $435.55 / $688.00	Professional		$268.83	$435.55	$688.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $103.06 / $136.91	Professional	26	$67.01	$103.06	$136.91
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $249.24 / $321.26 / $482.69	Professional	TC	$249.24	$321.26	$482.69
United Facility/Professional Professional Modifier Low / Median / High Price $240.81 / $368.89 / $497.53	Professional		$240.81	$368.89	$497.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.87 / $61.74 / $126.13	Professional	26	$60.87	$61.74	$126.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.76 / $298.85 / $371.40	Professional	TC	$179.76	$298.85	$371.40