Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.87 / $111.87 / $234.05	Facility		$111.87	$111.87	$234.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.41 / $60.41 / $132.31	Facility	26	$60.41	$60.41	$132.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.87 / $211.53 / $259.52	Professional		$111.87	$211.53	$259.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $60.41 / $117.54	Professional	26	$48.86	$60.41	$117.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $55.94 / $93.62 / $93.62	Professional	52	$55.94	$93.62	$93.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.46 / $162.66 / $202.54	Professional	TC	$51.46	$162.66	$202.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,943.54 / $10,793.37 / $17,587.65	Facility		$2,943.54	$10,793.37	$17,587.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.30 / $105.84 / $195.79	Professional		$55.30	$105.84	$195.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.59 / $64.59 / $64.59	Facility		$64.59	$64.59	$64.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.91 / $279.95 / $416.52	Professional		$137.91	$279.95	$416.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.21 / $77.90 / $126.75	Professional	26	$61.21	$77.90	$126.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.17 / $201.98 / $355.14	Professional	TC	$65.17	$201.98	$355.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $93.32 / $178.96	Professional		$32.34	$93.32	$178.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.12 / $510.42 / $705.92	Facility		$128.12	$510.42	$705.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $179.17 / $295.80 / $415.23	Professional		$179.17	$295.80	$415.23
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $61.21 / $77.90 / $126.52	Professional	26	$61.21	$77.90	$126.52
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $68.43 / $201.98 / $285.67	Professional	TC	$68.43	$201.98	$285.67
United Facility/Professional Professional Modifier Low / Median / High Price $167.09 / $288.89 / $423.43	Professional		$167.09	$288.89	$423.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.09 / $80.50 / $165.47	Professional	26	$56.09	$80.50	$165.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.67 / $175.58 / $330.49	Professional	TC	$78.67	$175.58	$330.49