Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.38 / $438.48 / $1,524.65	Professional		$278.38	$438.48	$1,524.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.23 / $96.08 / $328.00	Professional	26	$82.23	$96.08	$328.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.16 / $318.13 / $386.24	Professional	TC	$187.16	$318.13	$386.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.55 / $133.55 / $494.78	Professional		$133.55	$133.55	$494.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.55 / $133.55 / $165.10	Facility	26	$133.55	$133.55	$165.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.96 / $509.41 / $743.39	Professional		$400.96	$509.41	$743.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.87 / $133.55 / $212.05	Professional	26	$90.87	$133.55	$212.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $297.81 / $378.62 / $575.09	Professional	TC	$297.81	$378.62	$575.09
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $133.55 / $133.55 / $165.10	Facility	26	$133.55	$133.55	$165.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $309.91 / $500.52 / $801.13	Professional		$309.91	$500.52	$801.13
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $90.87 / $133.55 / $185.86	Professional	26	$90.87	$133.55	$185.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $280.02 / $361.22 / $542.73	Professional	TC	$280.02	$361.22	$542.73
United Facility/Professional Professional Modifier Low / Median / High Price $279.16 / $440.35 / $576.76	Professional		$279.16	$440.35	$576.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.52 / $84.00 / $162.88	Professional	26	$78.52	$84.00	$162.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.32 / $333.04 / $417.93	Professional	TC	$200.32	$333.04	$417.93