Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.13 / $90.20 / $172.37	Professional		$76.13	$90.20	$172.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.34 / $48.42 / $95.02	Professional	26	$45.34	$48.42	$95.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.23 / $165.74 / $205.00	Professional	50	$82.23	$165.74	$205.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.46 / $41.78 / $64.75	Professional	TC	$30.46	$41.78	$64.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $304.04 / $77,999.99 / $94,999.99	Facility		$304.04	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.32 / $47.32 / $75.72	Professional		$47.32	$47.32	$75.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.64 / $64.30 / $124.03	Facility		$32.64	$64.30	$124.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.32 / $47.32 / $58.50	Facility	26	$47.32	$47.32	$58.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.72 / $116.87 / $152.47	Professional		$75.72	$116.87	$152.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.32 / $54.41 / $87.30	Professional	26	$47.32	$54.41	$87.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $52.16 / $72.45	Professional	TC	$28.39	$52.16	$72.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.06 / $117.61 / $173.46	Facility		$44.06	$117.61	$173.46
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $47.32 / $47.32 / $58.50	Facility	26	$47.32	$47.32	$58.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.42 / $90.81 / $152.47	Professional		$49.42	$90.81	$152.47
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.32 / $50.96 / $87.30	Professional	26	$47.32	$50.96	$87.30
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $28.39 / $50.03 / $65.18	Professional	TC	$28.39	$50.03	$65.18
United Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $86.41 / $132.28	Professional		$53.77	$86.41	$132.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.11 / $48.95 / $56.96	Professional	26	$32.11	$48.95	$56.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $34.79 / $49.02	Professional	TC	$21.65	$34.79	$49.02