Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.58 / $95.60 / $640.58	Facility		$92.58	$95.60	$640.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $96.97 / $178.52	Professional		$79.40	$96.97	$178.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.96 / $59.17 / $220.72	Professional	26	$50.96	$59.17	$220.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.37 / $36.27 / $70.75	Professional	TC	$24.37	$36.27	$70.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.58 / $255.93 / $256.13	Professional		$228.58	$255.93	$256.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $136.24 / $151.19 / $152.66	Professional	26	$136.24	$151.19	$152.66
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.34 / $103.47 / $104.74	Professional	TC	$92.34	$103.47	$104.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.47 / $132.47 / $165.60	Professional		$132.47	$132.47	$165.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.44 / $78.44 / $98.06	Professional	26	$78.44	$78.44	$98.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.04 / $54.04 / $67.55	Professional	TC	$54.04	$54.04	$67.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.70 / $70.25 / $110.91	Facility		$59.70	$70.25	$110.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.40 / $219.68 / $643.49	Professional		$120.40	$219.68	$643.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $107.76 / $148.87 / $383.71	Professional	26	$107.76	$148.87	$383.71
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $42.01 / $77.06 / $350.03	Professional	TC	$42.01	$77.06	$350.03
United Facility/Professional Professional Modifier Low / Median / High Price $100.33 / $102.34 / $219.68	Professional		$100.33	$102.34	$219.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.19 / $66.63 / $142.61	Professional	26	$39.19	$66.63	$142.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $74.39 / $115.65	Professional	TC	$21.01	$74.39	$115.65