Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.82 / $4,945.75 / $4,945.75	Facility		$162.82	$4,945.75	$4,945.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.33 / $84.33 / $134.71	Facility	26	$84.33	$84.33	$134.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.59 / $205.49 / $300.60	Professional		$128.59	$205.49	$300.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $75.54 / $121.90	Professional	26	$48.86	$75.54	$121.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $64.30 / $76.55 / $105.77	Professional	52	$64.30	$76.55	$105.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.47 / $78.48 / $202.54	Professional	TC	$58.47	$78.48	$202.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.94 / $360.28 / $377.82	Professional		$291.94	$360.28	$377.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $159.12 / $196.36 / $205.25	Professional	26	$159.12	$196.36	$205.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.82 / $163.91 / $171.90	Professional	TC	$132.82	$163.91	$171.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.76 / $167.76 / $167.76	Facility		$167.76	$167.76	$167.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $94.06	Facility	26	$94.06	$94.06	$94.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.96 / $305.48 / $640.64	Professional		$154.96	$305.48	$640.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.14 / $115.71 / $199.07	Professional	26	$63.14	$115.71	$199.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.09 / $143.75 / $539.83	Professional	TC	$68.09	$143.75	$539.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $162.82 / $246.83 / $649.76	Facility		$162.82	$246.83	$649.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $178.12 / $323.86 / $3,102.49	Professional		$178.12	$323.86	$3,102.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.38 / $153.56 / $551.37	Professional	26	$66.38	$153.56	$551.37
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.40 / $198.15 / $2,808.09	Professional	TC	$94.40	$198.15	$2,808.09
United Facility/Professional Professional Modifier Low / Median / High Price $167.09 / $298.72 / $509.70	Professional		$167.09	$298.72	$509.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.73 / $133.30 / $198.94	Professional	26	$70.73	$133.30	$198.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.68 / $166.13 / $243.88	Professional	TC	$82.68	$166.13	$243.88