Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.25 / $115.25 / $184.98	Facility	26	$115.25	$115.25	$184.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.62 / $475.00 / $1,320.50	Professional		$339.62	$475.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.21 / $140.00 / $318.91	Professional	26	$103.21	$140.00	$318.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $155.71 / $184.11 / $262.27	Professional	52	$155.71	$184.11	$262.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $216.62 / $335.00 / $462.42	Professional	TC	$216.62	$335.00	$462.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $638.45 / $787.90 / $826.27	Professional		$638.45	$787.90	$826.27
BCBS Facility/Professional Professional Modifier 22 Low / Median / High Price $766.14 / $945.48 / $991.52	Professional	22	$766.14	$945.48	$991.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $213.04 / $262.91 / $274.79	Professional	26	$213.04	$262.91	$274.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $425.42 / $524.99 / $550.57	Professional	TC	$425.42	$524.99	$550.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.88 / $123.88 / $123.88	Facility	26	$123.88	$123.88	$123.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $465.61 / $725.00 / $1,453.62	Professional		$465.61	$725.00	$1,453.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.26 / $201.10 / $279.45	Professional	26	$115.26	$201.10	$279.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $321.02 / $506.55 / $1,234.59	Professional	TC	$321.02	$506.55	$1,234.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,013.76 / $1,013.76 / $1,013.76	Facility	26	$1,013.76	$1,013.76	$1,013.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $370.64 / $758.64 / $6,146.58	Professional		$370.64	$758.64	$6,146.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $126.76 / $230.50 / $921.60	Professional	26	$126.76	$230.50	$921.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $291.38 / $526.08 / $5,551.18	Professional	TC	$291.38	$526.08	$5,551.18
United Facility/Professional Professional Modifier Low / Median / High Price $392.26 / $684.23 / $1,204.58	Professional		$392.26	$684.23	$1,204.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.70 / $207.43 / $287.32	Professional	26	$99.70	$207.43	$287.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.35 / $476.80 / $798.00	Professional	TC	$253.35	$476.80	$798.00