Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.73 / $364.88 / $864.44	Facility		$166.73	$364.88	$864.44
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 $25.08 / $300.07 / $313.52	Facility	TC	$25.08	$300.07	$313.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.98 / $30.60 / $76.50	Professional		$7.98	$30.60	$76.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $8.55 / $53.40	Professional	26	$7.56	$8.55	$53.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.62 / $108.00 / $122.00	Professional	50	$63.62	$108.00	$122.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.68 / $16.70 / $18.02	Professional	52	$13.68	$16.70	$18.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $25.08 / $75.65	Professional	TC	$19.46	$25.08	$75.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.62 / $85.02 / $87.00	Professional		$65.62	$85.02	$87.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $19.48 / $20.35	Professional	26	$16.84	$19.48	$20.35
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $115.80 / $157.82 / $173.60	Professional	50	$115.80	$157.82	$173.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.18 / $63.29 / $66.38	Professional	TC	$50.18	$63.29	$66.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $38.40 / $38.40	Facility		$38.40	$38.40	$38.40
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 $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $52.00 / $84.28	Professional		$32.36	$52.00	$84.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $14.59 / $20.39	Professional	26	$8.39	$14.59	$20.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.21 / $40.09 / $62.54	Professional	TC	$22.21	$40.09	$62.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.54 / $54.02 / $119.70	Facility		$33.54	$54.02	$119.70
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $82.93 / $90.53 / $290.08	Facility	TC	$82.93	$90.53	$290.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.15 / $59.26 / $219.71	Professional		$31.15	$59.26	$219.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $16.89 / $67.70	Professional	26	$9.30	$16.89	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $44.90 / $168.70	Professional	TC	$23.99	$44.90	$168.70
United Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $58.71 / $84.34	Professional		$33.92	$58.71	$84.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $15.46 / $26.85	Professional	26	$8.75	$15.46	$26.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $43.30 / $61.93	Professional	TC	$23.99	$43.30	$61.93