Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.80 / $389.02 / $876.97	Facility		$101.80	$389.02	$876.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.67 / $45.42 / $86.55	Facility	26	$33.67	$45.42	$86.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $81.91 / $236.28 / $645.05	Facility	TC	$81.91	$236.28	$645.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.88 / $133.18 / $470.90	Professional		$95.88	$133.18	$470.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.38 / $39.85 / $138.67	Professional	26	$31.38	$39.85	$138.67
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.66 / $55.48 / $78.88	Professional	52	$44.66	$55.48	$78.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.81 / $88.53 / $180.04	Professional	TC	$63.81	$88.53	$180.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.00 / $350.00 / $437.00	Facility		$186.00	$350.00	$437.00
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $38.97 / $38.97 / $38.97	Facility	26	$38.97	$38.97	$38.97
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $79.78 / $79.78 / $79.78	Facility	TC	$79.78	$79.78	$79.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.48 / $130.02 / $221.58	Professional		$104.48	$130.02	$221.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.01 / $46.47 / $69.13	Professional	26	$34.01	$46.47	$69.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.58 / $89.27 / $152.20	Professional	TC	$69.58	$89.27	$152.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.16 / $235.80 / $428.79	Facility		$121.16	$235.80	$428.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.13 / $40.13 / $40.13	Facility	26	$40.13	$40.13	$40.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $82.40 / $82.40 / $82.40	Facility	TC	$82.40	$82.40	$82.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.58 / $152.72 / $247.12	Professional		$97.58	$152.72	$247.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.77 / $48.09 / $81.23	Professional	26	$30.77	$48.09	$81.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.61 / $103.50 / $175.89	Professional	TC	$64.61	$103.50	$175.89
United Facility/Professional Facility Modifier Low / Median / High Price $121.34 / $183.09 / $242.83	Facility		$121.34	$183.09	$242.83
United Facility/Professional Professional Modifier Low / Median / High Price $105.64 / $131.06 / $220.91	Professional		$105.64	$131.06	$220.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.40 / $41.28 / $70.88	Professional	26	$33.40	$41.28	$70.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.34 / $92.23 / $157.02	Professional	TC	$71.34	$92.23	$157.02