Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $208.93 / $912.01	Facility		$112.20	$208.93	$912.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $63.10 / $63.10	Facility	26	$34.67	$63.10	$63.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $79.43 / $144.54 / $724.44	Facility	TC	$79.43	$144.54	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $398.11 / $794.33	Professional		$56.23	$398.11	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $162.18 / $776.25	Professional	26	$31.62	$162.18	$776.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $93.33 / $181.97	Professional	TC	$37.15	$93.33	$181.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $70.79	Facility		$63.10	$63.10	$70.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $120.23	Professional		$67.61	$97.72	$120.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $20.42 / $38.02	Professional	26	$19.05	$20.42	$38.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $52.48 / $69.18	Professional	TC	$48.98	$52.48	$69.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $102.33 / $169.82	Professional		$46.77	$102.33	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $38.90 / $48.98	Professional	26	$14.45	$38.90	$48.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $70.79 / $125.89	Professional	TC	$32.36	$70.79	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $97.72 / $144.54	Professional		$33.11	$97.72	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $30.20 / $45.71	Professional	26	$10.72	$30.20	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $67.61 / $97.72	Professional	TC	$22.39	$67.61	$97.72