Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.97 / $471.20 / $959.42	Facility		$108.97	$471.20	$959.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.45 / $48.45 / $91.79	Facility	26	$48.45	$48.45	$91.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $281.01 / $342.30 / $950.00	Facility	TC	$281.01	$342.30	$950.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $118.44 / $453.90	Professional		$96.70	$118.44	$453.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.19 / $42.77 / $124.20	Professional	26	$26.19	$42.77	$124.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.45 / $88.68 / $153.44	Professional	TC	$71.45	$88.68	$153.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $591.42 / $77,999.99 / $94,999.99	Facility		$591.42	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.12 / $43.12 / $137.22	Professional		$43.12	$43.12	$137.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.37 / $137.22 / $358.59	Facility		$94.37	$137.22	$358.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.12 / $43.12 / $53.30	Facility	26	$43.12	$43.12	$53.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $94.12 / $94.12 / $116.35	Facility	TC	$94.12	$94.12	$116.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.61 / $137.22 / $198.58	Professional		$89.61	$137.22	$198.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.52 / $43.12 / $60.83	Professional	26	$29.52	$43.12	$60.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.97 / $94.12 / $137.75	Professional	TC	$59.97	$94.12	$137.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.07 / $161.49 / $199.87	Facility		$84.07	$161.49	$199.87
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $43.12 / $43.12 / $53.30	Facility	26	$43.12	$43.12	$53.30
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $94.12 / $94.12 / $116.35	Facility	TC	$94.12	$94.12	$116.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.53 / $150.74 / $248.21	Professional		$92.53	$150.74	$248.21
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $43.12 / $50.32	Professional	26	$34.86	$43.12	$50.32
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $62.80 / $94.12 / $110.12	Professional	TC	$62.80	$94.12	$110.12
United Facility/Professional Professional Modifier Low / Median / High Price $92.75 / $102.51 / $162.88	Professional		$92.75	$102.51	$162.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.95 / $30.24 / $52.60	Professional	26	$29.95	$30.24	$52.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.80 / $72.27 / $110.29	Professional	TC	$62.80	$72.27	$110.29