Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.68 / $132.68 / $132.68	Facility	26	$132.68	$132.68	$132.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $193.00 / $495.90	Professional		$113.34	$193.00	$495.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $50.95 / $142.00	Professional	26	$29.75	$50.95	$142.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $67.23 / $87.19 / $357.53	Professional	52	$67.23	$87.19	$357.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.59 / $104.09 / $216.12	Professional	TC	$83.59	$104.09	$216.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $51.00 / $188.24	Professional		$51.00	$51.00	$188.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.00 / $51.00 / $63.05	Facility	26	$51.00	$51.00	$63.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.90 / $188.24 / $265.69	Professional		$105.90	$188.24	$265.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.81 / $51.00 / $72.59	Professional	26	$34.81	$51.00	$72.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.37 / $137.22 / $185.01	Professional	TC	$67.37	$137.22	$185.01
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $51.00 / $51.00 / $63.05	Facility	26	$51.00	$51.00	$63.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.24 / $201.37 / $324.36	Professional		$125.24	$201.37	$324.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $41.07 / $51.00 / $59.24	Professional	26	$41.07	$51.00	$59.24
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $85.72 / $137.22 / $154.97	Professional	TC	$85.72	$137.22	$154.97
United Facility/Professional Professional Modifier Low / Median / High Price $119.10 / $125.23 / $219.93	Professional		$119.10	$125.23	$219.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.03 / $35.36 / $62.12	Professional	26	$35.03	$35.36	$62.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.07 / $89.86 / $152.00	Professional	TC	$84.07	$89.86	$152.00