Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $634.83 / $821.91 / $1,467.23	Professional		$634.83	$821.91	$1,467.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.20 / $171.66 / $505.95	Professional	26	$123.20	$171.66	$505.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $296.98 / $335.49 / $516.49	Professional	52	$296.98	$335.49	$516.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $506.85 / $654.21 / $927.64	Professional	TC	$506.85	$654.21	$927.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.81 / $189.81 / $1,028.99	Professional		$189.81	$189.81	$1,028.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $189.81 / $189.81 / $225.63	Facility	26	$189.81	$189.81	$225.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $668.84 / $1,004.10 / $1,453.76	Professional		$668.84	$1,004.10	$1,453.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.38 / $193.60 / $260.27	Professional	26	$123.38	$193.60	$260.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $545.47 / $810.50 / $1,193.48	Professional	TC	$545.47	$810.50	$1,193.48
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $189.81 / $189.81 / $225.63	Facility	26	$189.81	$189.81	$225.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $636.44 / $1,011.54 / $1,504.96	Professional		$636.44	$1,011.54	$1,504.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $103.59 / $184.23 / $211.03	Professional	26	$103.59	$184.23	$211.03
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $491.48 / $755.26 / $881.64	Professional	TC	$491.48	$755.26	$881.64
United Facility/Professional Professional Modifier Low / Median / High Price $916.98 / $1,071.83 / $1,756.58	Professional		$916.98	$1,071.83	$1,756.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $171.84 / $207.64 / $321.92	Professional	26	$171.84	$207.64	$321.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $734.40 / $849.60 / $1,146.23	Professional	TC	$734.40	$849.60	$1,146.23