Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.35 / $11.36 / $18.94	Facility	26	$11.35	$11.36	$18.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.65 / $348.05 / $406.71	Facility	TC	$32.65	$348.05	$406.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.16 / $49.16 / $190.80	Professional		$30.16	$49.16	$190.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $11.36 / $56.70	Professional	26	$10.02	$11.36	$56.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $78.72 / $86.98 / $145.66	Professional	50	$78.72	$86.98	$145.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.38 / $22.01 / $24.58	Professional	52	$18.38	$22.01	$24.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.50 / $37.81 / $240.30	Professional	TC	$27.50	$37.81	$240.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.36 / $117.21 / $120.43	Professional		$91.36	$117.21	$120.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.70 / $26.77 / $27.99	Professional	26	$21.70	$26.77	$27.99
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.48 / $219.70 / $240.86	Professional	50	$107.48	$219.70	$240.86
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.67 / $88.45 / $92.45	Professional	TC	$71.67	$88.45	$92.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.66 / $12.66 / $12.66	Facility	26	$12.66	$12.66	$12.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.63 / $40.63 / $40.63	Facility	TC	$40.63	$40.63	$40.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.74 / $72.56 / $114.30	Professional		$39.74	$72.56	$114.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.05 / $19.64 / $27.94	Professional	26	$11.05	$19.64	$27.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $56.33 / $86.10	Professional	TC	$26.89	$56.33	$86.10
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $160.75 / $178.31 / $219.53	Facility	TC	$160.75	$178.31	$219.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $79.73 / $297.63	Professional		$42.47	$79.73	$297.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.45 / $22.18 / $87.52	Professional	26	$12.45	$22.18	$87.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.20 / $57.10 / $229.42	Professional	TC	$31.20	$57.10	$229.42
United Facility/Professional Professional Modifier Low / Median / High Price $43.86 / $76.95 / $110.70	Professional		$43.86	$76.95	$110.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $20.74 / $28.36	Professional	26	$11.55	$20.74	$28.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.41 / $56.21 / $82.34	Professional	TC	$31.41	$56.21	$82.34