Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.89 / $676.40 / $983.25	Facility		$113.89	$676.40	$983.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.77 / $84.77 / $84.77	Facility	26	$84.77	$84.77	$84.77
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $304.18 / $444.10 / $460.47	Facility	TC	$304.18	$444.10	$460.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.23 / $126.53 / $521.00	Professional		$22.23	$126.53	$521.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.98 / $30.63 / $92.00	Professional	26	$20.98	$30.63	$92.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.26 / $112.49 / $184.17	Professional	TC	$102.26	$112.49	$184.17
BCBS Facility/Professional Facility Modifier Low / Median / High Price $935.60 / $77,999.99 / $94,999.99	Facility		$935.60	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.60 / $32.60 / $187.71	Professional		$32.60	$32.60	$187.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.28 / $223.13 / $578.66	Facility		$152.28	$223.13	$578.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.60 / $32.60 / $38.75	Facility	26	$32.60	$32.60	$38.75
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $155.11 / $155.11 / $184.38	Facility	TC	$155.11	$155.11	$184.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.24 / $187.71 / $257.79	Professional		$144.24	$187.71	$257.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.29 / $32.60 / $48.74	Professional	26	$22.29	$32.60	$48.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.76 / $155.11 / $209.05	Professional	TC	$117.76	$155.11	$209.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $152.28 / $257.32 / $314.99	Facility		$152.28	$257.32	$314.99
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $32.60 / $32.60 / $38.75	Facility	26	$32.60	$32.60	$38.75
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $155.11 / $155.11 / $184.38	Facility	TC	$155.11	$155.11	$184.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $199.63 / $322.56	Professional		$125.83	$199.63	$322.56
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $22.63 / $32.60 / $38.06	Professional	26	$22.63	$32.60	$38.06
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $117.76 / $155.11 / $178.67	Professional	TC	$117.76	$155.11	$178.67
United Facility/Professional Professional Modifier Low / Median / High Price $165.12 / $202.96 / $280.31	Professional		$165.12	$202.96	$280.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.24 / $36.56 / $40.96	Professional	26	$30.24	$36.56	$40.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.69 / $165.78 / $239.35	Professional	TC	$141.69	$165.78	$239.35