Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.30 / $129.90 / $172.58	Facility		$30.30	$129.90	$172.58
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 $21.83 / $21.83 / $40.47	Facility	TC	$21.83	$21.83	$40.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.26 / $30.30 / $64.97	Professional		$20.26	$30.30	$64.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.03 / $29.37	Professional	26	$7.03	$8.03	$29.37
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.00 / $33.00 / $33.00	Professional	50	$33.00	$33.00	$33.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.46 / $15.15 / $16.42	Professional	52	$12.46	$15.15	$16.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.83 / $64.97	Professional	TC	$17.89	$21.83	$64.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.80 / $76.28 / $79.98	Professional		$61.80	$76.28	$79.98
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 $123.60 / $152.56 / $159.97	Professional	50	$123.60	$152.56	$159.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.03 / $56.80 / $59.57	Professional	TC	$46.03	$56.80	$59.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $35.40 / $35.40	Facility		$35.40	$35.40	$35.40
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 $26.47 / $26.47 / $26.47	Facility	TC	$26.47	$26.47	$26.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.13 / $49.00 / $75.88	Professional		$30.13	$49.00	$75.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $14.34 / $20.07	Professional	26	$8.02	$14.34	$20.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.75 / $36.03 / $55.07	Professional	TC	$20.75	$36.03	$55.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.13 / $45.80 / $57.44	Facility		$29.13	$45.80	$57.44
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $159.00 / $175.51 / $200.90	Facility	TC	$159.00	$175.51	$200.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $53.88 / $200.17	Professional		$28.85	$53.88	$200.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $15.87 / $61.09	Professional	26	$8.59	$15.87	$61.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $37.78 / $154.00	Professional	TC	$19.80	$37.78	$154.00
United Facility/Professional Professional Modifier Low / Median / High Price $29.15 / $52.46 / $76.13	Professional		$29.15	$52.46	$76.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $15.60 / $21.12	Professional	26	$8.66	$15.60	$21.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.92 / $37.09 / $55.01	Professional	TC	$20.92	$37.09	$55.01