Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $593.75	Facility		$90.00	$90.00	$593.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.10 / $211.81 / $296.33	Professional		$150.10	$211.81	$296.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.94 / $61.00 / $208.95	Professional	26	$41.94	$61.00	$208.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.15 / $156.36 / $192.03	Professional	TC	$112.15	$156.36	$192.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $881.92 / $77,999.99 / $94,999.99	Facility		$881.92	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.99 / $60.99 / $214.53	Professional		$60.99	$60.99	$214.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $214.53 / $214.53 / $377.36	Facility		$214.53	$214.53	$377.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.99 / $60.99 / $72.50	Facility	26	$60.99	$60.99	$72.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.44 / $241.85 / $303.83	Professional		$139.44	$241.85	$303.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $67.26 / $86.76	Professional	26	$41.17	$67.26	$86.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.79 / $174.60 / $217.39	Professional	TC	$99.79	$174.60	$217.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $124.35 / $214.53 / $377.36	Facility		$124.35	$214.53	$377.36
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $60.99 / $60.99 / $72.50	Facility	26	$60.99	$60.99	$72.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $153.34 / $230.03 / $370.19	Professional		$153.34	$230.03	$370.19
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $60.99 / $86.76	Professional	26	$39.64	$60.99	$86.76
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $93.68 / $153.53 / $209.52	Professional	TC	$93.68	$153.53	$209.52
United Facility/Professional Professional Modifier Low / Median / High Price $238.68 / $277.19 / $387.20	Professional		$238.68	$277.19	$387.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.65 / $73.53 / $109.44	Professional	26	$56.65	$73.53	$109.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $175.49 / $206.49 / $277.76	Professional	TC	$175.49	$206.49	$277.76