Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.01 / $129.01 / $608.00	Facility	26	$129.01	$129.01	$608.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.50 / $225.19 / $989.00	Professional		$193.50	$225.19	$989.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $88.14 / $327.00	Professional	26	$75.45	$88.14	$327.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.99 / $137.25 / $592.00	Professional	TC	$112.99	$137.25	$592.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.30 / $128.30 / $296.02	Professional		$128.30	$128.30	$296.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.30 / $128.30 / $158.60	Facility	26	$128.30	$128.30	$158.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $224.66 / $296.02 / $470.15	Professional		$224.66	$296.02	$470.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.32 / $125.90 / $203.82	Professional	26	$94.32	$125.90	$203.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.63 / $167.73 / $256.99	Professional	TC	$121.63	$167.73	$256.99
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $128.30 / $128.30 / $158.60	Facility	26	$128.30	$128.30	$158.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $183.10 / $305.19 / $475.98	Professional		$183.10	$305.19	$475.98
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $94.32 / $128.30 / $169.96	Professional	26	$94.32	$128.30	$169.96
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $142.24 / $167.73 / $252.01	Professional	TC	$142.24	$167.73	$252.01
United Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $199.65 / $356.82	Professional		$172.70	$199.65	$356.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.77 / $78.04 / $156.55	Professional	26	$75.77	$78.04	$156.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.87 / $121.61 / $200.27	Professional	TC	$95.87	$121.61	$200.27