Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.34 / $164.74 / $210.86	Professional		$145.34	$164.74	$210.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.52 / $52.49 / $61.60	Professional	26	$48.52	$52.49	$61.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $112.25 / $217.50	Professional	TC	$96.82	$112.25	$217.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.20 / $65.20 / $279.73	Professional		$65.20	$65.20	$279.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.20 / $65.20 / $77.50	Facility	26	$65.20	$65.20	$77.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.59 / $254.92 / $279.73	Professional		$61.59	$254.92	$279.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $65.20 / $72.75	Professional	26	$28.51	$65.20	$72.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.08 / $182.17 / $214.53	Professional	TC	$33.08	$182.17	$214.53
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $65.20 / $65.20 / $77.50	Facility	26	$65.20	$65.20	$77.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $170.81 / $241.98 / $338.29	Professional		$170.81	$241.98	$338.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $65.20 / $72.75	Professional	26	$28.51	$65.20	$72.75
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $33.08 / $182.17 / $214.53	Professional	TC	$33.08	$182.17	$214.53
United Facility/Professional Professional Modifier Low / Median / High Price $106.99 / $110.44 / $184.06	Professional		$106.99	$110.44	$184.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $27.50 / $50.42	Professional	26	$27.50	$27.50	$50.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.48 / $82.94 / $138.22	Professional	TC	$79.48	$82.94	$138.22