Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.09 / $119.52 / $497.47	Professional		$103.09	$119.52	$497.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.72 / $28.83 / $118.82	Professional	26	$24.72	$28.83	$118.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.79 / $86.57 / $136.69	Professional	TC	$82.79	$86.57	$136.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.38 / $38.38 / $155.63	Professional		$38.38	$38.38	$155.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.38 / $38.38 / $45.63	Facility	26	$38.38	$38.38	$45.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.69 / $155.69 / $233.84	Professional		$112.69	$155.69	$233.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.06 / $38.38 / $55.90	Professional	26	$29.06	$38.38	$55.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.67 / $117.25 / $176.17	Professional	TC	$83.67	$117.25	$176.17
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $38.38 / $38.38 / $45.63	Facility	26	$38.38	$38.38	$45.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $103.05 / $177.75 / $278.93	Professional		$103.05	$177.75	$278.93
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $30.31 / $38.38 / $43.78	Professional	26	$30.31	$38.38	$43.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $90.32 / $117.25 / $161.80	Professional	TC	$90.32	$117.25	$161.80
United Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $167.40 / $197.12	Professional		$136.94	$167.40	$197.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.84 / $42.35 / $49.92	Professional	26	$35.84	$42.35	$49.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.10 / $121.53 / $159.02	Professional	TC	$101.10	$121.53	$159.02