Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.87 / $128.87 / $128.87	Facility		$128.87	$128.87	$128.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.36 / $13.26 / $37.02	Professional		$11.36	$13.26	$37.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $8.83 / $12.04	Professional	26	$7.72	$8.83	$12.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.36 / $11.36 / $11.36	Professional	50	$11.36	$11.36	$11.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.89 / $4.44 / $6.29	Professional	TC	$3.89	$4.44	$6.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.47 / $77,999.99 / $94,999.99	Facility		$53.47	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.09 / $12.09 / $17.88	Professional		$12.09	$12.09	$17.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6.12 / $12.06 / $23.26	Facility		$6.12	$12.06	$23.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $12.09 / $14.95	Facility	26	$12.09	$12.09	$14.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.36 / $18.07 / $27.24	Professional		$12.36	$18.07	$27.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.09 / $18.17	Professional	26	$9.77	$12.09	$18.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.83 / $6.43 / $9.81	Professional	TC	$2.83	$6.43	$9.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $8.26 / $17.88 / $25.93	Facility		$8.26	$17.88	$25.93
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.09 / $12.09 / $14.95	Facility	26	$12.09	$12.09	$14.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $11.92 / $20.91 / $33.92	Professional		$11.92	$20.91	$33.92
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $12.09 / $16.84	Professional	26	$11.55	$12.09	$16.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $3.58 / $6.69 / $9.38	Professional	TC	$3.58	$6.69	$9.38
United Facility/Professional Professional Modifier Low / Median / High Price $12.27 / $13.64 / $21.55	Professional		$12.27	$13.64	$21.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $9.59 / $14.72	Professional	26	$8.30	$9.59	$14.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.97 / $4.05 / $6.97	Professional	TC	$3.97	$4.05	$6.97