Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $476.00 / $913.21 / $941.40	Facility		$476.00	$913.21	$941.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.33 / $204.21 / $814.00	Professional		$193.33	$204.21	$814.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $34.25 / $57.21	Professional	26	$30.82	$34.25	$57.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $169.96 / $251.96	Professional	TC	$162.49	$169.96	$251.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,453.50 / $77,999.99 / $94,999.99	Facility		$1,453.50	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $58.89 / $284.45	Professional		$58.89	$58.89	$284.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $227.70 / $338.13 / $865.26	Facility		$227.70	$338.13	$865.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.89 / $58.89 / $70.00	Facility	26	$58.89	$58.89	$70.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.22 / $284.45 / $428.87	Professional		$186.22	$284.45	$428.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $58.89 / $85.11	Professional	26	$34.67	$58.89	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.08 / $225.57 / $363.97	Professional	TC	$146.08	$225.57	$363.97
Providence Facility/Professional Facility Modifier Low / Median / High Price $227.70 / $345.74 / $453.12	Facility		$227.70	$345.74	$453.12
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $58.89 / $58.89 / $70.00	Facility	26	$58.89	$58.89	$70.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $191.02 / $314.27 / $511.78	Professional		$191.02	$314.27	$511.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $40.14 / $58.89 / $66.88	Professional	26	$40.14	$58.89	$66.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $179.14 / $225.57 / $270.70	Professional	TC	$179.14	$225.57	$270.70
United Facility/Professional Professional Modifier Low / Median / High Price $268.32 / $313.89 / $500.42	Professional		$268.32	$313.89	$500.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.64 / $62.72 / $72.80	Professional	26	$52.64	$62.72	$72.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.60 / $247.81 / $341.12	Professional	TC	$201.60	$247.81	$341.12