Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $237.09 / $876.00	Professional		$215.53	$237.09	$876.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.52 / $74.72 / $268.00	Professional	26	$62.52	$74.72	$268.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $159.77 / $268.64	Professional	TC	$152.75	$159.77	$268.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.64 / $94.64 / $345.98	Professional		$94.64	$94.64	$345.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.64 / $94.64 / $112.50	Facility	26	$94.64	$94.64	$112.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.25 / $345.98 / $502.50	Professional		$231.25	$345.98	$502.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.95 / $94.64 / $138.57	Professional	26	$69.95	$94.64	$138.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.06 / $251.33 / $354.44	Professional	TC	$165.06	$251.33	$354.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $94.64 / $94.64 / $112.50	Facility	26	$94.64	$94.64	$112.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $234.13 / $389.36 / $600.20	Professional		$234.13	$389.36	$600.20
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $75.17 / $94.64 / $108.59	Professional	26	$75.17	$94.64	$108.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $179.02 / $251.33 / $295.44	Professional	TC	$179.02	$251.33	$295.44
United Facility/Professional Professional Modifier Low / Median / High Price $315.83 / $370.15 / $427.70	Professional		$315.83	$370.15	$427.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.84 / $106.79 / $119.68	Professional	26	$88.84	$106.79	$119.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.65 / $267.12 / $324.36	Professional	TC	$218.65	$267.12	$324.36