Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,012.82 / $1,092.93 / $4,933.00	Professional		$1,012.82	$1,092.93	$4,933.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $284.63 / $318.66 / $1,361.00	Professional	26	$284.63	$318.66	$1,361.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $728.19 / $802.67 / $1,226.36	Professional	TC	$728.19	$802.67	$1,226.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $451.66 / $451.66 / $1,617.36	Professional		$451.66	$451.66	$1,617.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $451.66 / $451.66 / $536.88	Facility	26	$451.66	$451.66	$536.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,141.88 / $1,617.36 / $2,416.56	Professional		$1,141.88	$1,617.36	$2,416.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $348.77 / $451.66 / $693.35	Professional	26	$348.77	$451.66	$693.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $793.11 / $1,165.70 / $1,723.21	Professional	TC	$793.11	$1,165.70	$1,723.21
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $451.66 / $451.66 / $536.88	Facility	26	$451.66	$451.66	$536.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,039.08 / $1,472.06 / $2,304.48	Professional		$1,039.08	$1,472.06	$2,304.48
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $348.77 / $451.66 / $693.35	Professional	26	$348.77	$451.66	$693.35
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $793.11 / $1,165.70 / $1,723.21	Professional	TC	$793.11	$1,165.70	$1,723.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,581.32 / $1,774.30 / $2,128.69	Professional		$1,581.32	$1,774.30	$2,128.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $402.32 / $513.61 / $790.89	Professional	26	$402.32	$513.61	$790.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,103.13 / $1,289.14 / $1,529.48	Professional	TC	$1,103.13	$1,289.14	$1,529.48