Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.77 / $110.77 / $110.77	Facility	26	$110.77	$110.77	$110.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $112.65 / $337.88	Professional		$75.00	$112.65	$337.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $29.52 / $117.45	Professional	26	$25.26	$29.52	$117.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.68 / $85.82 / $124.42	Professional	TC	$57.68	$85.82	$124.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.59 / $42.59 / $94.12	Professional		$42.59	$42.59	$94.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.59 / $42.59 / $52.65	Facility	26	$42.59	$42.59	$52.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.14 / $94.12 / $130.31	Professional		$47.14	$94.12	$130.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.16 / $42.59 / $63.99	Professional	26	$29.16	$42.59	$63.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.88 / $51.53 / $77.42	Professional	TC	$34.88	$51.53	$77.42
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $42.59 / $42.59 / $52.65	Facility	26	$42.59	$42.59	$52.65
Providence Facility/Professional Professional Modifier Low / Median / High Price $57.09 / $94.28 / $155.44	Professional		$57.09	$94.28	$155.44
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.03 / $42.59 / $49.10	Professional	26	$34.03	$42.59	$49.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $37.75 / $51.53 / $62.80	Professional	TC	$37.75	$51.53	$62.80
United Facility/Professional Professional Modifier Low / Median / High Price $59.91 / $84.66 / $108.78	Professional		$59.91	$84.66	$108.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.45 / $30.24 / $51.97	Professional	26	$29.45	$30.24	$51.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $42.84 / $78.54	Professional	TC	$30.32	$42.84	$78.54