Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.75 / $95.75 / $95.75	Facility	26	$95.75	$95.75	$95.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $101.59 / $505.00	Professional		$86.06	$101.59	$505.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.64 / $28.36 / $89.64	Professional	26	$24.64	$28.36	$89.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $66.56 / $140.53	Professional	TC	$61.40	$66.56	$140.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.49 / $40.49 / $168.26	Professional		$40.49	$40.49	$168.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.49 / $40.49 / $50.05	Facility	26	$40.49	$40.49	$50.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.83 / $160.18 / $249.92	Professional		$98.83	$160.18	$249.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $40.49 / $60.83	Professional	26	$28.14	$40.49	$60.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.48 / $113.62 / $191.97	Professional	TC	$68.48	$113.62	$191.97
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $40.49 / $40.49 / $50.05	Facility	26	$40.49	$40.49	$50.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.51 / $173.08 / $288.42	Professional		$112.51	$173.08	$288.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $32.74 / $40.49 / $47.15	Professional	26	$32.74	$40.49	$47.15
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $80.97 / $127.77 / $127.77	Professional	TC	$80.97	$127.77	$127.77
United Facility/Professional Professional Modifier Low / Median / High Price $108.78 / $115.85 / $203.45	Professional		$108.78	$115.85	$203.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $30.24 / $49.44	Professional	26	$28.15	$30.24	$49.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.54 / $87.70 / $154.01	Professional	TC	$78.54	$87.70	$154.01