Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.40 / $540.54 / $947.33	Facility		$113.40	$540.54	$947.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.18 / $179.54 / $287.79	Professional		$63.18	$179.54	$287.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.01 / $41.51 / $180.26	Professional	26	$29.01	$41.51	$180.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.15 / $170.38 / $240.37	Professional	TC	$50.15	$170.38	$240.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $260.60 / $77,999.99 / $94,999.99	Facility		$260.60	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $46.80 / $91.49	Professional		$46.80	$46.80	$91.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.14 / $77.09 / $148.71	Facility		$39.14	$77.09	$148.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.80 / $46.80 / $57.85	Facility	26	$46.80	$46.80	$57.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.11 / $91.62 / $163.46	Professional		$72.11	$91.62	$163.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.81 / $46.80 / $66.54	Professional	26	$33.81	$46.80	$66.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.77 / $44.69 / $129.88	Professional	TC	$32.77	$44.69	$129.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $52.83 / $148.71 / $368.12	Facility		$52.83	$148.71	$368.12
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $46.80 / $46.80 / $57.85	Facility	26	$46.80	$46.80	$57.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $99.65 / $167.36	Professional		$60.29	$99.65	$167.36
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $38.18 / $46.80 / $55.10	Professional	26	$38.18	$46.80	$55.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $35.43 / $44.69 / $120.28	Professional	TC	$35.43	$44.69	$120.28
United Facility/Professional Professional Modifier Low / Median / High Price $58.47 / $72.91 / $185.47	Professional		$58.47	$72.91	$185.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.47 / $34.65 / $57.04	Professional	26	$32.47	$34.65	$57.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.99 / $36.29 / $150.81	Professional	TC	$25.99	$36.29	$150.81