Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.61 / $189.31 / $328.23	Professional		$164.61	$189.31	$328.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.18 / $108.37 / $217.52	Professional	26	$96.18	$108.37	$217.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.20 / $79.70 / $121.40	Professional	TC	$68.20	$79.70	$121.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.47 / $162.47 / $276.05	Professional		$162.47	$162.47	$276.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $162.47 / $162.47 / $193.13	Facility	26	$162.47	$162.47	$193.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.43 / $248.45 / $749.58	Professional		$179.43	$248.45	$749.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.61 / $146.22 / $441.69	Professional	26	$105.61	$146.22	$441.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.81 / $102.21 / $307.89	Professional	TC	$73.81	$102.21	$307.89
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $162.47 / $162.47 / $193.13	Facility	26	$162.47	$162.47	$193.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $179.43 / $276.05 / $415.49	Professional		$179.43	$276.05	$415.49
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $84.99 / $146.22 / $179.96	Professional	26	$84.99	$146.22	$179.96
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $68.27 / $102.21 / $151.24	Professional	TC	$68.27	$102.21	$151.24
United Facility/Professional Professional Modifier Low / Median / High Price $232.63 / $313.77 / $444.45	Professional		$232.63	$313.77	$444.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $147.85 / $178.65 / $209.45	Professional	26	$147.85	$178.65	$209.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.32 / $136.88 / $159.12	Professional	TC	$112.32	$136.88	$159.12