Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.09 / $113.09 / $182.66	Facility	26	$113.09	$113.09	$182.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $438.79 / $494.36 / $693.97	Professional		$438.79	$494.36	$693.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.05 / $132.85 / $169.26	Professional	26	$103.05	$132.85	$169.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $381.27 / $524.71	Professional	TC	$335.00	$381.27	$524.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $938.29 / $1,157.91 / $1,214.31	Professional		$938.29	$1,157.91	$1,214.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $210.41 / $259.66 / $271.39	Professional	26	$210.41	$259.66	$271.39
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $727.88 / $898.25 / $943.33	Professional	TC	$727.88	$898.25	$943.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.33 / $122.33 / $122.33	Facility	26	$122.33	$122.33	$122.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $692.20 / $1,019.43 / $1,608.78	Professional		$692.20	$1,019.43	$1,608.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.81 / $197.79 / $273.29	Professional	26	$113.81	$197.79	$273.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $549.41 / $798.61 / $1,333.54	Professional	TC	$549.41	$798.61	$1,333.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $1,000.96 / $1,000.96 / $1,000.96	Facility	26	$1,000.96	$1,000.96	$1,000.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $634.40 / $1,127.50 / $5,967.97	Professional		$634.40	$1,127.50	$5,967.97
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $113.80 / $216.24 / $937.83	Professional	26	$113.80	$216.24	$937.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $517.79 / $910.17 / $5,400.50	Professional	TC	$517.79	$910.17	$5,400.50
United Facility/Professional Professional Modifier Low / Median / High Price $581.20 / $1,054.92 / $1,410.76	Professional		$581.20	$1,054.92	$1,410.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.76 / $205.98 / $282.14	Professional	26	$114.76	$205.98	$282.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $447.52 / $826.64 / $1,128.60	Professional	TC	$447.52	$826.64	$1,128.60