Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.91 / $157.58 / $167.25	Professional		$130.91	$157.58	$167.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.91 / $18.92 / $19.66	Professional	26	$15.91	$18.92	$19.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.34 / $138.69 / $148.33	Professional	TC	$112.34	$138.69	$148.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.14 / $23.14 / $209.27	Professional		$23.14	$23.14	$209.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.14 / $23.14 / $23.14	Facility	26	$23.14	$23.14	$23.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.71 / $156.16 / $209.27	Professional		$128.71	$156.16	$209.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.09 / $20.77 / $23.38	Professional	26	$17.09	$20.77	$23.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.61 / $133.47 / $186.13	Professional	TC	$111.61	$133.47	$186.13
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $23.14 / $23.14 / $23.14	Facility	26	$23.14	$23.14	$23.14
Providence Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $177.88 / $236.88	Professional		$119.70	$177.88	$236.88
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $20.77 / $23.14	Professional	26	$19.23	$20.77	$23.14
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $122.69 / $147.68 / $186.13	Professional	TC	$122.69	$147.68	$186.13
United Facility/Professional Professional Modifier Low / Median / High Price $138.61 / $176.40 / $199.64	Professional		$138.61	$176.40	$199.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.22 / $24.52 / $27.26	Professional	26	$20.22	$24.52	$27.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.00 / $149.59 / $172.38	Professional	TC	$114.00	$149.59	$172.38