Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.04 / $108.04 / $174.20	Facility	26	$108.04	$108.04	$174.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.36 / $475.00 / $652.70	Professional		$378.36	$475.00	$652.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.04 / $140.00 / $278.57	Professional	26	$104.04	$140.00	$278.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.95 / $335.00 / $491.07	Professional	TC	$290.95	$335.00	$491.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $750.81 / $982.23 / $1,005.14	Professional		$750.81	$982.23	$1,005.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $200.55 / $247.48 / $258.68	Professional	26	$200.55	$247.48	$258.68
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $566.78 / $699.45 / $736.10	Professional	TC	$566.78	$699.45	$736.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $564.00 / $832.47 / $1,400.87	Professional		$564.00	$832.47	$1,400.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.69 / $187.25 / $261.06	Professional	26	$108.69	$187.25	$261.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $427.83 / $649.79 / $1,203.80	Professional	TC	$427.83	$649.79	$1,203.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $953.92 / $953.92 / $953.92	Facility	26	$953.92	$953.92	$953.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $521.76 / $947.12 / $5,981.06	Professional		$521.76	$947.12	$5,981.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $108.24 / $215.14 / $883.52	Professional	26	$108.24	$215.14	$883.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $402.71 / $731.98 / $5,438.76	Professional	TC	$402.71	$731.98	$5,438.76
United Facility/Professional Professional Modifier Low / Median / High Price $458.34 / $853.79 / $1,403.81	Professional		$458.34	$853.79	$1,403.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $194.81 / $269.49	Professional	26	$100.00	$194.81	$269.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $312.70 / $695.59 / $1,029.23	Professional	TC	$312.70	$695.59	$1,029.23