Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $731.63 / $954.60 / $4,352.00	Professional		$731.63	$954.60	$4,352.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.85 / $187.33 / $649.47	Professional	26	$106.85	$187.33	$649.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $316.98 / $383.34 / $2,346.23	Professional	52	$316.98	$383.34	$2,346.23
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $126.79 / $153.34 / $938.49	Professional	53	$126.79	$153.34	$938.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $617.39 / $767.25 / $1,018.78	Professional	TC	$617.39	$767.25	$1,018.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.51 / $173.51 / $1,151.50	Professional		$173.51	$173.51	$1,151.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.51 / $173.51 / $206.25	Facility	26	$173.51	$173.51	$206.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $943.53 / $1,151.50 / $1,836.20	Professional		$943.53	$1,151.50	$1,836.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $173.51 / $203.50 / $317.77	Professional	26	$173.51	$203.50	$317.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $752.75 / $977.99 / $1,536.46	Professional	TC	$752.75	$977.99	$1,536.46
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $173.51 / $173.51 / $206.25	Facility	26	$173.51	$173.51	$206.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $754.40 / $1,257.41 / $1,821.29	Professional		$754.40	$1,257.41	$1,821.29
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $173.51 / $216.31 / $317.77	Professional	26	$173.51	$216.31	$317.77
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $752.75 / $981.98 / $1,469.40	Professional	TC	$752.75	$981.98	$1,469.40
United Facility/Professional Professional Modifier Low / Median / High Price $1,229.08 / $1,413.45 / $1,641.41	Professional		$1,229.08	$1,413.45	$1,641.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $186.67 / $231.97 / $351.65	Professional	26	$186.67	$231.97	$351.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $994.07 / $1,180.80 / $1,325.43	Professional	TC	$994.07	$1,180.80	$1,325.43