Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.97 / $328.87 / $442.89	Facility		$164.97	$328.87	$442.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.11 / $8.11 / $13.10	Facility	26	$8.11	$8.11	$13.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.55 / $313.52 / $321.89	Facility	TC	$22.55	$313.52	$321.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.48 / $30.49 / $63.90	Professional		$20.48	$30.49	$63.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.11 / $31.50	Professional	26	$7.33	$8.11	$31.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $100.23 / $100.23 / $100.23	Professional	50	$100.23	$100.23	$100.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $22.55 / $67.64	Professional	TC	$17.57	$22.55	$67.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.46 / $77.09 / $80.56	Professional		$62.46	$77.09	$80.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.12 / $18.67 / $19.51	Professional	26	$15.12	$18.67	$19.51
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $124.92 / $154.18 / $161.13	Professional	50	$124.92	$154.18	$161.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.34 / $58.42 / $61.06	Professional	TC	$47.34	$58.42	$61.06
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 $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.85 / $26.85 / $26.85	Facility	TC	$26.85	$26.85	$26.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $51.19 / $76.81	Professional		$30.78	$51.19	$76.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.21 / $13.96 / $19.52	Professional	26	$8.21	$13.96	$19.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.13 / $37.04 / $56.63	Professional	TC	$21.13	$37.04	$56.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.67 / $50.88 / $133.11	Facility		$30.67	$50.88	$133.11
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $75.17 / $91.40 / $106.13	Facility	TC	$75.17	$91.40	$106.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.49 / $56.95 / $202.34	Professional		$29.49	$56.95	$202.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $16.89 / $75.00	Professional	26	$8.75	$16.89	$75.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $40.58 / $163.00	Professional	TC	$21.60	$40.58	$163.00
United Facility/Professional Professional Modifier Low / Median / High Price $29.49 / $55.87 / $77.05	Professional		$29.49	$55.87	$77.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $14.99 / $20.19	Professional	26	$8.59	$14.99	$20.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.31 / $38.35 / $54.86	Professional	TC	$22.31	$38.35	$54.86