Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.05 / $277.58 / $1,130.91	Facility		$88.05	$277.58	$1,130.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.01 / $94.71 / $417.00	Professional		$81.01	$94.71	$417.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $44.89 / $157.00	Professional	26	$30.44	$44.89	$157.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $111.06 / $528.51 / $832.00	Professional	50	$111.06	$528.51	$832.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.56 / $59.68 / $238.00	Professional	TC	$50.56	$59.68	$238.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $514.54 / $77,999.99 / $94,999.99	Facility		$514.54	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.08 / $134.08 / $134.08	Professional		$134.08	$134.08	$134.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.92 / $134.08 / $311.27	Facility		$81.92	$134.08	$311.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.48 / $50.48 / $62.40	Facility	26	$50.48	$50.48	$62.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.87 / $134.08 / $190.51	Professional		$93.87	$134.08	$190.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.29 / $50.48 / $71.09	Professional	26	$37.29	$50.48	$71.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.38 / $83.60 / $112.32	Professional	TC	$56.38	$83.60	$112.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $82.12 / $111.95 / $165.75	Facility		$82.12	$111.95	$165.75
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $50.48 / $50.48 / $62.40	Facility	26	$50.48	$50.48	$62.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $89.03 / $146.66 / $228.22	Professional		$89.03	$146.66	$228.22
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.22 / $50.48 / $58.02	Professional	26	$40.22	$50.48	$58.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $64.75 / $83.60 / $95.79	Professional	TC	$64.75	$83.60	$95.79
United Facility/Professional Professional Modifier Low / Median / High Price $89.14 / $92.92 / $156.55	Professional		$89.14	$92.92	$156.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $36.14 / $60.86	Professional	26	$34.65	$36.14	$60.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.49 / $56.78 / $95.69	Professional	TC	$54.49	$56.78	$95.69