Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $323.59 / $524.81	Facility		$112.20	$323.59	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $16.60	Facility	26	$8.91	$8.91	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $33.11 / $288.40	Facility	TC	$28.84	$33.11	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $39.81 / $120.23	Professional		$8.91	$39.81	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $17.38 / $43.65	Professional	26	$8.32	$17.38	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $81.28 / $144.54	Professional	50	$38.02	$81.28	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $58.88 / $204.17	Professional	TC	$26.92	$58.88	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $104.71	Professional		$70.79	$93.33	$104.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $23.44	Professional	26	$15.85	$20.89	$23.44
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $190.55 / $208.93	Professional	50	$141.25	$190.55	$208.93
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $74.13 / $81.28	Professional	TC	$54.95	$74.13	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $61.66 / $97.72	Professional		$33.88	$61.66	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.18 / $22.91	Professional	26	$8.13	$13.18	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $48.98 / $74.13	Professional	TC	$25.12	$48.98	$74.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $70.79 / $186.21	Facility		$38.90	$70.79	$186.21
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $89.13 / $112.20 / $147.91	Facility	TC	$89.13	$112.20	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $67.61 / $263.03	Professional		$35.48	$67.61	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $19.05 / $50.12	Professional	26	$11.48	$19.05	$50.12
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $51.29 / $204.17	Professional	TC	$28.18	$51.29	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $61.66 / $95.50	Professional		$35.48	$61.66	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.14 / $23.99	Professional	26	$9.33	$15.14	$23.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $44.67 / $74.13	Professional	TC	$26.30	$44.67	$74.13