Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.37 / $647.09 / $1,098.90	Facility		$186.37	$647.09	$1,098.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.97 / $36.97 / $59.44	Facility	26	$36.97	$36.97	$59.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $77.41 / $126.95 / $460.95	Facility	TC	$77.41	$126.95	$460.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.95 / $132.93 / $195.31	Professional		$100.95	$132.93	$195.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $35.53 / $97.01	Professional	26	$31.67	$35.53	$97.01
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.24 / $57.19 / $57.30	Professional	52	$46.24	$57.19	$57.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.78 / $99.56 / $260.77	Professional	TC	$68.78	$99.56	$260.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.38 / $262.08 / $274.52	Professional		$212.38	$262.08	$274.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.38 / $84.38 / $88.21	Professional	26	$68.38	$84.38	$88.21
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.00 / $177.70 / $186.36	Professional	TC	$144.00	$177.70	$186.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.16 / $121.16 / $121.16	Facility		$121.16	$121.16	$121.16
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 $124.69 / $203.00 / $288.31	Professional		$124.69	$203.00	$288.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.94 / $64.70 / $89.06	Professional	26	$39.94	$64.70	$89.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.68 / $133.06 / $197.82	Professional	TC	$84.68	$133.06	$197.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $114.38 / $185.90 / $391.73	Facility		$114.38	$185.90	$391.73
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $294.57 / $377.65 / $389.98	Facility	TC	$294.57	$377.65	$389.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $206.55 / $704.47	Professional		$115.13	$206.55	$704.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $44.44 / $74.06 / $290.60	Professional	26	$44.44	$74.06	$290.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $77.59 / $145.94 / $483.33	Professional	TC	$77.59	$145.94	$483.33
United Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $195.08 / $287.64	Professional		$115.13	$195.08	$287.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.53 / $62.96 / $92.23	Professional	26	$37.53	$62.96	$92.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.59 / $137.22 / $195.41	Professional	TC	$77.59	$137.22	$195.41