Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.89 / $111.78 / $400.00	Professional		$99.89	$111.78	$400.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.21 / $35.77 / $103.50	Professional	26	$31.21	$35.77	$103.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.67 / $74.53 / $130.10	Professional	TC	$68.67	$74.53	$130.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.53 / $51.53 / $172.99	Professional		$51.53	$51.53	$172.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.53 / $51.53 / $63.70	Facility	26	$51.53	$51.53	$63.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.03 / $142.63 / $237.52	Professional		$111.03	$142.63	$237.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.52 / $44.03 / $77.42	Professional	26	$37.52	$44.03	$77.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.51 / $96.32 / $164.85	Professional	TC	$73.51	$96.32	$164.85
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $51.53 / $51.53 / $63.70	Facility	26	$51.53	$51.53	$63.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.67 / $182.79 / $285.08	Professional		$109.67	$182.79	$285.08
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.38 / $51.53 / $77.42	Professional	26	$30.38	$51.53	$77.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $68.67 / $121.46 / $182.49	Professional	TC	$68.67	$121.46	$182.49
United Facility/Professional Professional Modifier Low / Median / High Price $109.56 / $112.83 / $193.93	Professional		$109.56	$112.83	$193.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.45 / $36.50 / $62.75	Professional	26	$35.45	$36.50	$62.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.11 / $76.33 / $131.18	Professional	TC	$74.11	$76.33	$131.18