Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $409.27 / $2,414.00 / $7,365.00	Facility		$409.27	$2,414.00	$7,365.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.39 / $45.25 / $53.49	Facility	26	$36.39	$45.25	$53.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.44 / $208.15 / $779.03	Professional		$144.44	$208.15	$779.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.39 / $45.26 / $246.96	Professional	26	$36.39	$45.26	$246.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $108.87 / $172.52 / $578.12	Professional	TC	$108.87	$172.52	$578.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $821.00 / $1,963.00 / $4,852.00	Facility		$821.00	$1,963.00	$4,852.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.10 / $172.75 / $315.08	Professional		$132.10	$172.75	$315.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.00 / $55.73 / $95.09	Professional	26	$43.00	$55.73	$95.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $86.06 / $122.53 / $255.64	Professional	TC	$86.06	$122.53	$255.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.71 / $264.56 / $766.24	Professional		$159.71	$264.56	$766.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.78 / $66.14 / $223.80	Professional	26	$40.78	$66.14	$223.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.54 / $187.39 / $515.27	Professional	TC	$105.54	$187.39	$515.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $96.43 / $288.75 / $961.00	Facility		$96.43	$288.75	$961.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $101.77 / $181.86 / $181.86	Facility	26	$101.77	$181.86	$181.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $161.97 / $285.41 / $1,531.99	Professional		$161.97	$285.41	$1,531.99
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.17 / $74.65 / $907.84	Professional	26	$47.17	$74.65	$907.84
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $109.72 / $205.72 / $1,117.24	Professional	TC	$109.72	$205.72	$1,117.24
United Facility/Professional Facility Modifier Low / Median / High Price $245.00 / $760.00 / $1,300.00	Facility		$245.00	$760.00	$1,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $152.91 / $231.37 / $397.37	Professional		$152.91	$231.37	$397.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.77 / $55.98 / $102.69	Professional	26	$39.77	$55.98	$102.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.72 / $170.54 / $330.57	Professional	TC	$109.72	$170.54	$330.57