Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.67 / $198.34 / $390.60	Facility		$50.67	$198.34	$390.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.48 / $8.48 / $13.70	Facility	26	$8.48	$8.48	$13.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.02 / $202.38 / $693.35	Facility	TC	$20.02	$202.38	$693.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $28.51 / $59.63	Professional		$23.03	$28.51	$59.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $8.19 / $29.37	Professional	26	$6.74	$8.19	$29.37
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $103.54 / $103.54 / $103.54	Professional	50	$103.54	$103.54	$103.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.69 / $21.35 / $59.63	Professional	TC	$17.69	$21.35	$59.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.87 / $71.41 / $74.63	Professional		$57.87	$71.41	$74.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.78 / $19.48 / $20.35	Professional	26	$15.78	$19.48	$20.35
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $115.74 / $142.82 / $149.26	Professional	50	$115.74	$142.82	$149.26
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.08 / $51.93 / $54.28	Professional	TC	$42.08	$51.93	$54.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $32.79 / $32.79	Facility		$32.79	$32.79	$32.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.09 / $47.49 / $72.28	Professional		$29.09	$47.49	$72.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $13.66 / $20.07	Professional	26	$8.02	$13.66	$20.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.92 / $34.00 / $51.68	Professional	TC	$20.92	$34.00	$51.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.50 / $44.96 / $57.24	Facility		$28.50	$44.96	$57.24
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $109.18 / $210.16 / $1,625.00	Facility	TC	$109.18	$210.16	$1,625.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $54.31 / $187.12	Professional		$28.54	$54.31	$187.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $16.18 / $67.70	Professional	26	$8.23	$16.18	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $38.44 / $160.00	Professional	TC	$20.21	$38.44	$160.00
United Facility/Professional Professional Modifier Low / Median / High Price $28.87 / $49.16 / $71.59	Professional		$28.87	$49.16	$71.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $15.37 / $21.12	Professional	26	$8.66	$15.37	$21.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $35.49 / $50.47	Professional	TC	$20.21	$35.49	$50.47