Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.75 / $166.73 / $421.89	Facility		$31.75	$166.73	$421.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.48 / $8.48 / $13.10	Facility	26	$8.48	$8.48	$13.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.27 / $23.27 / $42.23	Facility	TC	$23.27	$23.27	$42.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.89 / $30.36 / $69.42	Professional		$22.89	$30.36	$69.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.19 / $25.20	Professional	26	$7.03	$8.19	$25.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.78 / $15.72 / $17.14	Professional	52	$12.78	$15.72	$17.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $23.27 / $72.90	Professional	TC	$18.53	$23.27	$72.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.76 / $80.06 / $81.93	Professional		$61.76	$80.06	$81.93
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 $81.42 / $148.52 / $163.38	Professional	50	$81.42	$148.52	$163.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.00 / $59.24 / $62.12	Professional	TC	$48.00	$59.24	$62.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.15 / $36.15 / $36.15	Facility		$36.15	$36.15	$36.15
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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.13 / $49.00 / $80.38	Professional		$30.13	$49.00	$80.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.68 / $13.96 / $19.50	Professional	26	$7.68	$13.96	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $37.56 / $58.80	Professional	TC	$21.01	$37.56	$58.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.75 / $47.48 / $60.32	Facility		$31.75	$47.48	$60.32
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $63.94 / $71.98 / $142.00	Facility	TC	$63.94	$71.98	$142.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $56.66 / $206.66	Professional		$30.51	$56.66	$206.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $16.05 / $67.70	Professional	26	$8.59	$16.05	$67.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $42.62 / $157.81	Professional	TC	$22.28	$42.62	$157.81
United Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $55.84 / $79.77	Professional		$32.11	$55.84	$79.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.28 / $15.46 / $21.12	Professional	26	$8.28	$15.46	$21.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $42.62 / $58.65	Professional	TC	$22.28	$42.62	$58.65