Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.87 / $357.84 / $580.50	Facility		$128.87	$357.84	$580.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.83 / $8.84 / $15.02	Facility	26	$8.83	$8.84	$15.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.19 / $42.22 / $304.13	Facility	TC	$22.19	$42.22	$304.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.48 / $32.93 / $78.30	Professional		$8.48	$32.93	$78.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.48 / $32.93	Professional	26	$7.33	$8.48	$32.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $124.32 / $124.32 / $124.32	Professional	50	$124.32	$124.32	$124.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.19 / $25.89 / $151.19	Professional	TC	$22.19	$25.89	$151.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.05 / $81.70 / $83.62	Professional		$63.05	$81.70	$83.62
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.44 / $20.29 / $21.21	Professional	26	$16.44	$20.29	$21.21
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $74.18 / $151.60 / $166.78	Professional	50	$74.18	$151.60	$166.78
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.00 / $59.24 / $62.12	Professional	TC	$48.00	$59.24	$62.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.90 / $36.90 / $36.90	Facility		$36.90	$36.90	$36.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.71 / $55.00 / $81.34	Professional		$32.71	$55.00	$81.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $15.23 / $20.96	Professional	26	$8.39	$15.23	$20.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.07 / $38.20 / $60.78	Professional	TC	$24.07	$38.20	$60.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.03 / $51.65 / $130.51	Facility		$31.03	$51.65	$130.51
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $173.98 / $223.80 / $292.05	Facility	TC	$173.98	$223.80	$292.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $60.84 / $208.83	Professional		$31.40	$60.84	$208.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $17.62 / $74.30	Professional	26	$9.69	$17.62	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.38 / $44.70 / $176.00	Professional	TC	$22.38	$44.70	$176.00
United Facility/Professional Professional Modifier Low / Median / High Price $31.40 / $57.24 / $91.69	Professional		$31.40	$57.24	$91.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $15.86 / $22.01	Professional	26	$9.02	$15.86	$22.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.38 / $39.29 / $55.94	Professional	TC	$22.38	$39.29	$55.94