Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.58 / $262.16 / $776.47	Professional		$137.58	$262.16	$776.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.70 / $147.68 / $886.10	Professional	26	$55.70	$147.68	$886.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.44 / $94.98 / $379.54	Professional	TC	$68.44	$94.98	$379.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.64 / $94.64 / $198.23	Professional		$94.64	$94.64	$198.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.64 / $94.64 / $117.00	Facility	26	$94.64	$94.64	$117.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.63 / $198.23 / $302.61	Professional		$163.63	$198.23	$302.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.73 / $70.09 / $123.01	Professional	26	$58.73	$70.09	$123.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.80 / $115.06 / $179.60	Professional	TC	$86.80	$115.06	$179.60
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $94.64 / $94.64 / $117.00	Facility	26	$94.64	$94.64	$117.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.74 / $166.82 / $247.93	Professional		$120.74	$166.82	$247.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $58.73 / $94.64 / $149.40	Professional	26	$58.73	$94.64	$149.40
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $103.58 / $115.06 / $179.60	Professional	TC	$103.58	$115.06	$179.60
United Facility/Professional Professional Modifier Low / Median / High Price $162.85 / $192.90 / $228.80	Professional		$162.85	$192.90	$228.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.50 / $81.01 / $110.29	Professional	26	$78.50	$81.01	$110.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.35 / $112.92 / $179.45	Professional	TC	$84.35	$112.92	$179.45