Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $760.00 / $3,576.00 / $7,500.00	Facility		$760.00	$3,576.00	$7,500.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.65 / $141.65 / $141.65	Facility	26	$141.65	$141.65	$141.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $428.72 / $428.72 / $459.27	Professional		$428.72	$428.72	$459.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $141.65 / $141.65 / $184.32	Professional	26	$141.65	$141.65	$184.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.94 / $287.07 / $291.98	Professional	TC	$274.94	$287.07	$291.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,032.01 / $1,628.01 / $2,590.41	Facility		$1,032.01	$1,628.01	$2,590.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.63 / $367.85 / $505.11	Professional		$128.63	$367.85	$505.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $334.26 / $458.22 / $535.34	Professional		$334.26	$458.22	$535.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.90 / $171.71 / $200.86	Professional	26	$129.90	$171.71	$200.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.46 / $286.26 / $321.98	Professional	TC	$199.46	$286.26	$321.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $382.63 / $488.00 / $2,743.00	Facility		$382.63	$488.00	$2,743.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $319.48 / $564.64 / $564.64	Facility	26	$319.48	$564.64	$564.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $327.32 / $462.92 / $2,844.40	Professional		$327.32	$462.92	$2,844.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $112.28 / $171.72 / $930.32	Professional	26	$112.28	$171.72	$930.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $202.39 / $278.29 / $1,914.08	Professional	TC	$202.39	$278.29	$1,914.08
United Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $1,279.00 / $2,637.00	Facility		$375.00	$1,279.00	$2,637.00
United Facility/Professional Professional Modifier Low / Median / High Price $308.06 / $404.76 / $649.70	Professional		$308.06	$404.76	$649.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.64 / $145.30 / $222.86	Professional	26	$109.64	$145.30	$222.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $197.60 / $252.99 / $426.84	Professional	TC	$197.60	$252.99	$426.84