Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.36 / $277.58 / $1,113.20	Professional		$252.36	$277.58	$1,113.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.26 / $97.12 / $391.83	Professional	26	$87.26	$97.12	$391.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.09 / $172.59 / $261.02	Professional	TC	$165.09	$172.59	$261.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.24 / $127.24 / $365.96	Professional		$127.24	$127.24	$365.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.24 / $127.24 / $151.25	Facility	26	$127.24	$127.24	$151.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.94 / $365.96 / $535.41	Professional		$277.94	$365.96	$535.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.53 / $127.24 / $185.37	Professional	26	$100.53	$127.24	$185.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.76 / $238.71 / $358.66	Professional	TC	$158.76	$238.71	$358.66
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $127.24 / $127.24 / $151.25	Facility	26	$127.24	$127.24	$151.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $244.65 / $407.70 / $635.48	Professional		$244.65	$407.70	$635.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $102.08 / $127.24 / $145.26	Professional	26	$102.08	$127.24	$145.26
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $177.41 / $238.71 / $302.64	Professional	TC	$177.41	$238.71	$302.64
United Facility/Professional Professional Modifier Low / Median / High Price $325.41 / $391.16 / $444.28	Professional		$325.41	$391.16	$444.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $118.79 / $140.36 / $168.97	Professional	26	$118.79	$140.36	$168.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $202.07 / $248.37 / $298.67	Professional	TC	$202.07	$248.37	$298.67