Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.46 / $551.00 / $2,062.61	Facility		$114.46	$551.00	$2,062.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $249.00	Facility	26	$124.62	$124.62	$249.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.62 / $170.74 / $612.00	Professional		$122.62	$170.74	$612.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.96 / $52.85 / $188.96	Professional	26	$35.96	$52.85	$188.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.95 / $109.52 / $437.00	Professional	TC	$87.95	$109.52	$437.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $781.87 / $77,999.99 / $94,999.99	Facility		$781.87	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.42 / $59.42 / $183.50	Professional		$59.42	$59.42	$183.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.22 / $183.50 / $475.84	Facility		$125.22	$183.50	$475.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.42 / $59.42 / $73.45	Facility	26	$59.42	$59.42	$73.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.14 / $183.50 / $267.55	Professional		$124.14	$183.50	$267.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.88 / $59.42 / $84.36	Professional	26	$40.88	$59.42	$84.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.00 / $124.09 / $181.59	Professional	TC	$81.00	$124.09	$181.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $113.20 / $213.65 / $262.49	Facility		$113.20	$213.65	$262.49
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $59.42 / $59.42 / $73.45	Facility	26	$59.42	$59.42	$73.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.73 / $201.95 / $322.58	Professional		$123.73	$201.95	$322.58
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $47.73 / $59.42 / $68.90	Professional	26	$47.73	$59.42	$68.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $87.13 / $124.09 / $145.63	Professional	TC	$87.13	$124.09	$145.63
United Facility/Professional Professional Modifier Low / Median / High Price $125.23 / $135.32 / $219.93	Professional		$125.23	$135.32	$219.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $41.86 / $69.59	Professional	26	$41.17	$41.86	$69.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.37 / $93.65 / $146.41	Professional	TC	$83.37	$93.65	$146.41