Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.92 / $129.78 / $536.00	Professional		$115.92	$129.78	$536.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $22.82 / $35.07	Professional	26	$20.50	$22.82	$35.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.26 / $106.95 / $161.71	Professional	TC	$102.26	$106.95	$161.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.90 / $77,999.99 / $94,999.99	Facility		$918.90	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.81 / $36.81 / $186.13	Professional		$36.81	$36.81	$186.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.57 / $221.25 / $560.77	Facility		$147.57	$221.25	$560.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.81 / $36.81 / $43.75	Facility	26	$36.81	$36.81	$43.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.78 / $186.13 / $296.64	Professional		$129.78	$186.13	$296.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.45 / $36.81 / $53.15	Professional	26	$22.45	$36.81	$53.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.36 / $149.33 / $253.67	Professional	TC	$104.36	$149.33	$253.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $147.57 / $243.67 / $312.45	Facility		$147.57	$243.67	$312.45
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $36.81 / $36.81 / $43.75	Facility	26	$36.81	$36.81	$43.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.73 / $198.46 / $352.12	Professional		$123.73	$198.46	$352.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $24.72 / $36.81 / $41.97	Professional	26	$24.72	$36.81	$41.97
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $115.66 / $149.33 / $171.17	Professional	TC	$115.66	$149.33	$171.17
United Facility/Professional Facility Modifier Low / Median / High Price $110.74 / $110.74 / $110.74	Facility		$110.74	$110.74	$110.74
United Facility/Professional Professional Modifier Low / Median / High Price $167.86 / $201.79 / $277.12	Professional		$167.86	$201.79	$277.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.60 / $39.68 / $44.80	Professional	26	$33.60	$39.68	$44.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.15 / $160.49 / $237.44	Professional	TC	$137.15	$160.49	$237.44