Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.92 / $139.32 / $215.21	Facility	26	$120.92	$139.32	$215.21
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $161.16 / $168.91 / $196.93	Facility	53	$161.16	$168.91	$196.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $731.63 / $973.78 / $1,818.54	Professional		$731.63	$973.78	$1,818.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.90 / $187.33 / $458.28	Professional	26	$109.90	$187.33	$458.28
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $345.55 / $414.74 / $566.40	Professional	52	$345.55	$414.74	$566.40
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $138.22 / $165.89 / $226.56	Professional	53	$138.22	$165.89	$226.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $617.39 / $767.25 / $1,160.76	Professional	TC	$617.39	$767.25	$1,160.76
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $161.15 / $161.15 / $161.15	Facility	26	$161.15	$161.15	$161.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $740.41 / $968.42 / $1,626.24	Professional		$740.41	$968.42	$1,626.24
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.06 / $177.72 / $310.83	Professional	26	$114.06	$177.72	$310.83
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $614.91 / $801.00 / $1,381.06	Professional	TC	$614.91	$801.00	$1,381.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.71 / $126.71 / $126.71	Facility	26	$126.71	$126.71	$126.71
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $163.30 / $163.30 / $163.30	Facility	53	$163.30	$163.30	$163.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $787.74 / $1,153.10 / $1,858.16	Professional		$787.74	$1,153.10	$1,858.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.06 / $212.62 / $333.65	Professional	26	$124.06	$212.62	$333.65
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $1,303.05 / $1,303.05 / $1,441.67	Professional	53	$1,303.05	$1,303.05	$1,441.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $630.63 / $934.49 / $1,553.11	Professional	TC	$630.63	$934.49	$1,553.11
United Facility/Professional Professional Modifier Low / Median / High Price $807.54 / $1,097.05 / $1,792.11	Professional		$807.54	$1,097.05	$1,792.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $127.29 / $196.79 / $324.99	Professional	26	$127.29	$196.79	$324.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $656.93 / $927.26 / $1,493.06	Professional	TC	$656.93	$927.26	$1,493.06