Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.48 / $106.48 / $158.40	Facility		$106.48	$106.48	$158.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.13 / $84.81 / $125.52	Professional		$48.13	$84.81	$125.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.33 / $32.04 / $70.01	Professional	26	$28.33	$32.04	$70.01
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $51.30 / $205.20 / $334.86	Professional	50	$51.30	$205.20	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.48 / $35.57 / $167.43	Professional	52	$28.48	$35.57	$167.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.88 / $58.14 / $85.65	Professional	TC	$29.88	$58.14	$85.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $333.84 / $77,999.99 / $94,999.99	Facility		$333.84	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $46.80 / $74.14	Professional		$46.80	$46.80	$74.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.81 / $88.13 / $181.66	Facility		$47.81	$88.13	$181.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.80 / $46.80 / $55.63	Facility	26	$46.80	$46.80	$55.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $93.42 / $165.27	Professional		$66.73	$93.42	$165.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.16 / $46.80 / $68.06	Professional	26	$28.16	$46.80	$68.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.61 / $60.79 / $96.61	Professional	TC	$24.61	$60.79	$96.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.81 / $96.61 / $154.33	Facility		$47.81	$96.61	$154.33
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $46.80 / $46.80 / $55.63	Facility	26	$46.80	$46.80	$55.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.17 / $90.52 / $147.83	Professional		$51.17	$90.52	$147.83
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $31.95 / $46.80 / $53.89	Professional	26	$31.95	$46.80	$53.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.61 / $55.22 / $96.61	Professional	TC	$24.61	$55.22	$96.61
United Facility/Professional Professional Modifier Low / Median / High Price $83.56 / $107.61 / $139.69	Professional		$83.56	$107.61	$139.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $49.28 / $55.78	Professional	26	$39.70	$49.28	$55.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.36 / $51.92 / $91.29	Professional	TC	$41.36	$51.92	$91.29