Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.27 / $400.14 / $485.32	Facility		$78.27	$400.14	$485.32
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.48 / $13.69 / $14.41	Facility	26	$8.48	$13.69	$14.41
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.36 / $284.95 / $643.78	Facility	TC	$24.36	$284.95	$643.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.92 / $32.83 / $86.96	Professional		$7.92	$32.83	$86.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.48 / $42.00	Professional	26	$7.33	$8.48	$42.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.60 / $15.60 / $112.16	Professional	50	$15.60	$15.60	$112.16
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.70 / $16.42 / $18.02	Professional	52	$13.70	$16.42	$18.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $27.86 / $225.90	Professional	TC	$21.32	$27.86	$225.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.62 / $85.02 / $87.00	Professional		$65.62	$85.02	$87.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $19.48 / $20.35	Professional	26	$16.84	$19.48	$20.35
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $115.80 / $157.82 / $173.60	Professional	50	$115.80	$157.82	$173.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.18 / $63.29 / $66.38	Professional	TC	$50.18	$63.29	$66.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $38.40 / $38.40	Facility		$38.40	$38.40	$38.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.64 / $51.77 / $83.16	Professional		$30.64	$51.77	$83.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $14.59 / $20.39	Professional	26	$8.39	$14.59	$20.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.61 / $40.09 / $61.39	Professional	TC	$22.61	$40.09	$61.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.83 / $55.65 / $148.27	Facility		$32.83	$55.65	$148.27
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $76.08 / $90.41 / $169.46	Facility	TC	$76.08	$90.41	$169.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.94 / $59.86 / $221.82	Professional		$31.94	$59.86	$221.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.83 / $16.89 / $71.00	Professional	26	$11.83	$16.89	$71.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.31 / $43.32 / $170.86	Professional	TC	$23.31	$43.32	$170.86
United Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $58.20 / $82.49	Professional		$32.22	$58.20	$82.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $15.60 / $21.12	Professional	26	$8.66	$15.60	$21.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.71 / $39.22 / $61.37	Professional	TC	$22.71	$39.22	$61.37