Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.84 / $461.05 / $748.49	Professional		$354.84	$461.05	$748.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.38 / $65.43 / $107.18	Professional	26	$55.38	$65.43	$107.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $177.42 / $203.80 / $307.38	Professional	52	$177.42	$203.80	$307.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $299.45 / $392.78 / $652.12	Professional	TC	$299.45	$392.78	$652.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.49 / $91.49 / $646.73	Professional		$91.49	$91.49	$646.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.49 / $91.49 / $108.75	Facility	26	$91.49	$91.49	$108.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $420.46 / $595.29 / $917.17	Professional		$420.46	$595.29	$917.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.47 / $90.40 / $124.67	Professional	26	$59.47	$90.40	$124.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $369.81 / $511.29 / $792.50	Professional	TC	$369.81	$511.29	$792.50
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $91.49 / $91.49 / $108.75	Facility	26	$91.49	$91.49	$108.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $401.00 / $604.44 / $915.34	Professional		$401.00	$604.44	$915.34
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $50.65 / $82.34 / $103.76	Professional	26	$50.65	$82.34	$103.76
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $360.91 / $499.72 / $666.39	Professional	TC	$360.91	$499.72	$666.39
United Facility/Professional Professional Modifier Low / Median / High Price $585.99 / $712.38 / $842.39	Professional		$585.99	$712.38	$842.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.43 / $103.26 / $141.44	Professional	26	$86.43	$103.26	$141.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $467.52 / $584.39 / $703.02	Professional	TC	$467.52	$584.39	$703.02