Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.21 / $163.03 / $570.19	Professional		$147.21	$163.03	$570.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $70.88 / $251.62	Professional	26	$52.54	$70.88	$251.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.84 / $110.48 / $121.53	Professional	TC	$68.84	$110.48	$121.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.79 / $107.79 / $219.26	Professional		$107.79	$107.79	$219.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.79 / $107.79 / $133.25	Facility	26	$107.79	$107.79	$133.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.10 / $242.30 / $365.83	Professional		$193.10	$242.30	$365.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.83 / $94.87 / $161.94	Professional	26	$55.83	$94.87	$161.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.30 / $148.76 / $277.10	Professional	TC	$100.30	$148.76	$277.10
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $107.79 / $107.79 / $133.25	Facility	26	$107.79	$107.79	$133.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.49 / $215.63 / $342.34	Professional		$137.49	$215.63	$342.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $56.21 / $95.55 / $110.60	Professional	26	$56.21	$95.55	$110.60
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $87.02 / $111.47 / $167.48	Professional	TC	$87.02	$111.47	$167.48
United Facility/Professional Professional Modifier Low / Median / High Price $124.98 / $147.62 / $270.00	Professional		$124.98	$147.62	$270.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.92 / $64.42 / $133.11	Professional	26	$49.92	$64.42	$133.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.26 / $97.16 / $144.00	Professional	TC	$66.26	$97.16	$144.00