Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.01 / $116.90 / $214.70	Professional		$107.01	$116.90	$214.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $20.71 / $31.81	Professional	26	$11.65	$20.71	$31.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.84 / $102.06 / $189.87	Professional	TC	$87.84	$102.06	$189.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,286.43 / $64,999.99 / $68,099.99	Facility		$1,286.43	$64,999.99	$68,099.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $36.28 / $231.88	Professional		$36.28	$36.28	$231.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $226.15 / $231.88 / $397.09	Facility		$226.15	$231.88	$397.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.28 / $36.28 / $36.28	Facility	26	$36.28	$36.28	$36.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.10 / $207.58 / $450.16	Professional		$143.10	$207.58	$450.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.53 / $31.79 / $61.66	Professional	26	$18.53	$31.79	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.61 / $178.70 / $382.58	Professional	TC	$120.61	$178.70	$382.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.34 / $185.53 / $342.55	Facility		$128.34	$185.53	$342.55
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $36.28 / $36.28 / $36.28	Facility	26	$36.28	$36.28	$36.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $176.06 / $316.52 / $411.76	Professional		$176.06	$316.52	$411.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $18.53 / $32.65 / $41.90	Professional	26	$18.53	$32.65	$41.90
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $110.60 / $178.59 / $223.49	Professional	TC	$110.60	$178.59	$223.49
United Facility/Professional Professional Modifier Low / Median / High Price $215.11 / $262.77 / $406.06	Professional		$215.11	$262.77	$406.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.80 / $39.04 / $46.86	Professional	26	$20.80	$39.04	$46.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.28 / $217.12 / $314.87	Professional	TC	$169.28	$217.12	$314.87