Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.59 / $197.12 / $744.49	Professional		$154.59	$197.12	$744.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $170.18 / $504.31	Professional	26	$90.92	$170.18	$504.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.01 / $100.62 / $110.68	Professional	TC	$31.01	$100.62	$110.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.20 / $167.20 / $223.99	Professional		$167.20	$167.20	$223.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $167.20 / $167.20 / $206.70	Facility	26	$167.20	$167.20	$206.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.16 / $305.70 / $464.35	Professional		$170.16	$305.70	$464.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.64 / $118.37 / $209.01	Professional	26	$99.64	$118.37	$209.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.18 / $96.69 / $362.44	Professional	TC	$46.18	$96.69	$362.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $167.20 / $167.20 / $206.70	Facility	26	$167.20	$167.20	$206.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $133.93 / $182.40 / $307.02	Professional		$133.93	$182.40	$307.02
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $99.64 / $167.20 / $263.94	Professional	26	$99.64	$167.20	$263.94
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $56.79 / $77.41 / $332.88	Professional	TC	$56.79	$77.41	$332.88
United Facility/Professional Professional Modifier Low / Median / High Price $170.98 / $223.61 / $383.87	Professional		$170.98	$223.61	$383.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $135.05 / $138.50 / $194.58	Professional	26	$135.05	$138.50	$194.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $45.63 / $143.34	Professional	TC	$32.47	$45.63	$143.34