Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.59 / $89.59 / $89.59	Facility	26	$89.59	$89.59	$89.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $88.15 / $239.99	Professional		$79.34	$88.15	$239.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $30.99 / $118.80	Professional	26	$23.46	$30.99	$118.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.46 / $228.44 / $490.00	Professional	52	$46.46	$228.44	$490.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.64 / $63.28 / $91.93	Professional	TC	$53.64	$63.28	$91.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.06 / $42.06 / $89.91	Professional		$42.06	$42.06	$89.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.06 / $42.06 / $52.00	Facility	26	$42.06	$42.06	$52.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.67 / $106.36 / $172.69	Professional		$82.67	$106.36	$172.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.40 / $42.06 / $56.38	Professional	26	$27.40	$42.06	$56.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.85 / $71.89 / $110.12	Professional	TC	$47.85	$71.89	$110.12
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $42.06 / $42.06 / $52.00	Facility	26	$42.06	$42.06	$52.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.99 / $107.95 / $173.57	Professional		$60.99	$107.95	$173.57
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.94 / $42.06 / $46.06	Professional	26	$31.94	$42.06	$46.06
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $47.85 / $71.89 / $103.76	Professional	TC	$47.85	$71.89	$103.76
United Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $84.81 / $142.02	Professional		$80.48	$84.81	$142.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.57 / $29.59 / $51.97	Professional	26	$27.57	$29.59	$51.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.89 / $56.78 / $89.37	Professional	TC	$50.89	$56.78	$89.37