Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $76.65 / $346.00	Facility		$35.54	$76.65	$346.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.85 / $48.78 / $67.51	Facility	26	$34.85	$48.78	$67.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.22 / $55.89 / $96.10	Professional		$44.22	$55.89	$96.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.04 / $34.56 / $48.78	Professional	26	$29.04	$34.56	$48.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $96.01 / $96.01 / $96.01	Professional	50	$96.01	$96.01	$96.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $19.05 / $36.89	Professional	TC	$16.42	$19.05	$36.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $344.00 / $456.72 / $761.25	Facility		$344.00	$456.72	$761.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.12 / $137.12 / $137.12	Professional		$137.12	$137.12	$137.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.79 / $139.05 / $455.25	Facility		$53.79	$139.05	$455.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.20 / $81.76 / $187.00	Professional		$40.20	$81.76	$187.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.80 / $47.43 / $83.00	Professional	26	$25.80	$47.43	$83.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.64 / $34.33 / $104.00	Professional	TC	$14.64	$34.33	$104.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.63 / $68.08 / $197.57	Facility		$45.63	$68.08	$197.57
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $70.02 / $198.78 / $198.78	Facility	26	$70.02	$198.78	$198.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $98.25 / $659.45	Professional		$53.77	$98.25	$659.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.11 / $54.87 / $335.18	Professional	26	$32.11	$54.87	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $52.12 / $404.98	Professional	TC	$21.65	$52.12	$404.98
United Facility/Professional Facility Modifier Low / Median / High Price $114.42 / $209.50 / $214.74	Facility		$114.42	$209.50	$214.74
United Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $93.83 / $140.29	Professional		$53.77	$93.83	$140.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.11 / $45.95 / $68.44	Professional	26	$32.11	$45.95	$68.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.19 / $33.89 / $61.69	Professional	TC	$21.19	$33.89	$61.69