Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $88.33 / $115.90	Professional		$64.48	$88.33	$115.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.56 / $34.85 / $79.37	Professional	26	$26.56	$34.85	$79.37
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.00 / $41.31 / $44.17	Professional	52	$23.00	$41.31	$44.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.18 / $52.82 / $91.12	Professional	TC	$26.18	$52.82	$91.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.54 / $41.54 / $99.90	Professional		$41.54	$41.54	$99.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.30 / $54.30 / $99.90	Facility		$54.30	$54.30	$99.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.54 / $41.54 / $41.54	Facility	26	$41.54	$41.54	$41.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.76 / $89.54 / $100.94	Professional		$69.76	$89.54	$100.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.02 / $37.39 / $41.97	Professional	26	$31.02	$37.39	$41.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.72 / $50.46 / $58.97	Professional	TC	$38.72	$50.46	$58.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $55.01 / $65.04 / $103.55	Facility		$55.01	$65.04	$103.55
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $41.54 / $41.54 / $41.54	Facility	26	$41.54	$41.54	$41.54
Providence Facility/Professional Professional Modifier Low / Median / High Price $59.52 / $89.30 / $116.25	Professional		$59.52	$89.30	$116.25
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $37.39 / $41.68	Professional	26	$34.90	$37.39	$41.68
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $43.57 / $50.46 / $58.36	Professional	TC	$43.57	$50.46	$58.36
United Facility/Professional Professional Modifier Low / Median / High Price $83.66 / $105.02 / $126.60	Professional		$83.66	$105.02	$126.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.88 / $44.46 / $49.44	Professional	26	$35.88	$44.46	$49.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.00 / $59.00 / $78.58	Professional	TC	$47.00	$59.00	$78.58