Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $233.47 / $633.77 / $638.32	Facility		$233.47	$633.77	$638.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $645.30 / $645.30 / $645.30	Facility	TC	$645.30	$645.30	$645.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.49 / $208.24 / $884.00	Professional		$178.49	$208.24	$884.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $35.54 / $69.25	Professional	26	$26.96	$35.54	$69.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $169.77 / $345.46	Professional	TC	$162.34	$169.77	$345.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,111.73 / $77,999.99 / $94,999.99	Facility		$2,111.73	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $58.36 / $379.10	Professional		$58.36	$58.36	$379.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $328.55 / $450.63 / $1,248.47	Facility		$328.55	$450.63	$1,248.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.36 / $58.36 / $69.38	Facility	26	$58.36	$58.36	$69.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $320.74 / $320.74 / $381.25	Facility	TC	$320.74	$320.74	$381.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.15 / $379.10 / $546.20	Professional		$249.15	$379.10	$546.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.72 / $58.36 / $85.32	Professional	26	$30.72	$58.36	$85.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.90 / $320.74 / $460.88	Professional	TC	$208.90	$320.74	$460.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $312.05 / $469.64 / $647.23	Facility		$312.05	$469.64	$647.23
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $58.36 / $58.36 / $69.38	Facility	26	$58.36	$58.36	$69.38
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $320.74 / $320.74 / $381.25	Facility	TC	$320.74	$320.74	$381.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $255.51 / $428.93 / $655.01	Professional		$255.51	$428.93	$655.01
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.25 / $58.36 / $67.20	Professional	26	$40.25	$58.36	$67.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $260.08 / $320.74 / $393.28	Professional	TC	$260.08	$320.74	$393.28
United Facility/Professional Professional Modifier Low / Median / High Price $336.99 / $421.80 / $522.88	Professional		$336.99	$421.80	$522.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.99 / $61.60 / $72.15	Professional	26	$46.99	$61.60	$72.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $305.58 / $357.54 / $471.03	Professional	TC	$305.58	$357.54	$471.03