Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $277.32 / $277.32 / $277.32	Facility		$277.32	$277.32	$277.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.00 / $85.12 / $85.12	Facility	26	$21.00	$85.12	$85.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $142.85 / $278.42 / $278.42	Facility	TC	$142.85	$278.42	$278.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $72.94 / $115.00	Professional		$36.86	$72.94	$115.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.59 / $71.59 / $71.59	Professional	25	$71.59	$71.59	$71.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.52 / $22.03 / $60.78	Professional	26	$19.52	$22.03	$60.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $89.26 / $234.74 / $234.74	Professional	50	$89.26	$234.74	$234.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.25 / $17.47 / $50.18	Professional	52	$16.25	$17.47	$50.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.49 / $53.22 / $97.79	Professional	TC	$14.49	$53.22	$97.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $249.13 / $77,999.99 / $94,999.99	Facility		$249.13	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.07 / $32.07 / $58.36	Professional		$32.07	$32.07	$58.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.68 / $69.38 / $71.43	Facility		$40.68	$69.38	$71.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.07 / $32.07 / $38.13	Facility	26	$32.07	$32.07	$38.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.29 / $26.29 / $31.25	Facility	TC	$26.29	$26.29	$31.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $81.44 / $129.19	Professional		$58.36	$81.44	$129.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.73 / $31.71 / $49.65	Professional	26	$22.73	$31.71	$49.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.29 / $53.00 / $89.63	Professional	TC	$26.29	$53.00	$89.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $35.90 / $70.70 / $136.62	Facility		$35.90	$70.70	$136.62
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $32.07 / $32.07 / $38.13	Facility	26	$32.07	$32.07	$38.13
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $26.29 / $26.29 / $31.25	Facility	TC	$26.29	$26.29	$31.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $66.20 / $99.57	Professional		$35.36	$66.20	$99.57
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.44 / $33.64 / $48.19	Professional	26	$22.44	$33.64	$48.19
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.66 / $58.62 / $89.63	Professional	TC	$23.66	$58.62	$89.63
United Facility/Professional Professional Modifier Low / Median / High Price $64.76 / $77.45 / $122.11	Professional		$64.76	$77.45	$122.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.10 / $36.54 / $57.35	Professional	26	$31.10	$36.54	$57.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.65 / $39.60 / $84.70	Professional	TC	$33.65	$39.60	$84.70