Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $187.21 / $290.85 / $406.50	Facility		$187.21	$290.85	$406.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.42 / $53.42 / $53.42	Facility	26	$53.42	$53.42	$53.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $88.75 / $238.85 / $290.85	Facility	TC	$88.75	$238.85	$290.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $42.01 / $111.60	Professional		$17.98	$42.01	$111.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $8.68 / $42.45	Professional	26	$6.67	$8.68	$42.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.29 / $16.27 / $16.32	Professional	52	$12.29	$16.27	$16.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $24.29 / $31.93	Professional	TC	$17.91	$24.29	$31.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.37 / $155.88 / $200.64	Facility		$93.37	$155.88	$200.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.99 / $45.54 / $68.20	Professional		$40.99	$45.54	$68.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $10.33 / $16.47	Professional	26	$7.23	$10.33	$16.47
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.65 / $35.21 / $36.34	Professional	TC	$24.65	$35.21	$36.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.18 / $173.34 / $304.72	Facility		$132.18	$173.34	$304.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $55.72 / $82.36	Professional		$31.42	$55.72	$82.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.35 / $12.47 / $17.87	Professional	26	$7.35	$12.47	$17.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.06 / $43.25 / $65.22	Professional	TC	$24.06	$43.25	$65.22
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $44.28 / $85.50	Professional		$27.54	$44.28	$85.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $10.42 / $17.96	Professional	26	$5.75	$10.42	$17.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.96 / $33.13 / $62.80	Professional	TC	$19.96	$33.13	$62.80