Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $427.94 / $2,340.00	Professional		$342.85	$427.94	$2,340.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.56 / $99.85 / $414.00	Professional	26	$68.56	$99.85	$414.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.27 / $310.45 / $2,205.51	Professional	TC	$274.27	$310.45	$2,205.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.57 / $113.57 / $626.75	Professional		$113.57	$113.57	$626.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.57 / $113.57 / $140.40	Facility	26	$113.57	$113.57	$140.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $626.75 / $692.00 / $1,219.15	Professional		$626.75	$692.00	$1,219.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.39 / $113.57 / $215.86	Professional	26	$88.39	$113.57	$215.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $513.17 / $565.70 / $1,003.29	Professional	TC	$513.17	$565.70	$1,003.29
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $113.57 / $113.57 / $140.40	Facility	26	$113.57	$113.57	$140.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $387.96 / $532.48 / $692.00	Professional		$387.96	$532.48	$692.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $88.77 / $113.57 / $157.94	Professional	26	$88.77	$113.57	$157.94
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $513.17 / $513.17 / $565.70	Professional	TC	$513.17	$513.17	$565.70
United Facility/Professional Professional Modifier Low / Median / High Price $340.38 / $391.43 / $808.72	Professional		$340.38	$391.43	$808.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.88 / $72.09 / $138.18	Professional	26	$66.88	$72.09	$138.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.29 / $324.55 / $926.82	Professional	TC	$268.29	$324.55	$926.82