Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.95 / $424.06 / $807.56	Facility		$125.95	$424.06	$807.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.84 / $8.84 / $16.35	Facility	26	$8.84	$8.84	$16.35
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.13 / $294.20 / $600.14	Facility	TC	$30.13	$294.20	$600.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.34 / $36.85 / $88.20	Professional		$8.34	$36.85	$88.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.63 / $8.52 / $32.04	Professional	26	$7.63	$8.52	$32.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.00 / $125.66 / $125.66	Professional	50	$75.00	$125.66	$125.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $31.62 / $174.44	Professional	TC	$25.37	$31.62	$174.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.78 / $102.35 / $105.16	Professional		$79.78	$102.35	$105.16
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 $105.16 / $191.84 / $210.32	Professional	50	$105.16	$191.84	$210.32
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.09 / $80.33 / $83.97	Professional	TC	$65.09	$80.33	$83.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.23 / $46.23 / $46.23	Facility		$46.23	$46.23	$46.23
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 $36.90 / $36.90 / $36.90	Facility	TC	$36.90	$36.90	$36.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $62.93 / $97.91	Professional		$32.00	$62.93	$97.91
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 $23.04 / $50.75 / $77.56	Professional	TC	$23.04	$50.75	$77.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.97 / $60.91 / $144.87	Facility		$38.97	$60.91	$144.87
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $144.08 / $206.77 / $268.45	Facility	TC	$144.08	$206.77	$268.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.36 / $70.81 / $263.06	Professional		$37.36	$70.81	$263.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $17.48 / $67.70	Professional	26	$9.69	$17.48	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.80 / $53.50 / $209.88	Professional	TC	$28.80	$53.50	$209.88
United Facility/Professional Professional Modifier Low / Median / High Price $39.11 / $70.81 / $97.99	Professional		$39.11	$70.81	$97.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $16.26 / $22.01	Professional	26	$9.02	$16.26	$22.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.43 / $51.26 / $75.98	Professional	TC	$29.43	$51.26	$75.98