Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $201.99 / $290.01	Facility		$27.30	$201.99	$290.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.07 / $23.37 / $31.67	Facility	26	$23.07	$23.37	$31.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.90 / $80.09 / $233.75	Professional		$35.90	$80.09	$233.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $33.02 / $78.78	Professional	26	$23.37	$33.02	$78.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $115.34 / $209.18 / $402.38	Professional	50	$115.34	$209.18	$402.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.96 / $19.79 / $42.41	Professional	52	$17.96	$19.79	$42.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.83 / $32.58 / $156.02	Professional	TC	$12.83	$32.58	$156.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $86.79 / $133.47	Professional		$66.30	$86.79	$133.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $36.01 / $54.66	Professional	26	$27.04	$36.01	$54.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $99.45 / $130.18 / $200.22	Professional	50	$99.45	$130.18	$200.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $54.67 / $84.40	Professional	TC	$28.87	$54.67	$84.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $135.13	Facility		$52.57	$52.57	$135.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.36 / $91.73 / $171.16	Professional		$46.36	$91.73	$171.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.02 / $41.51 / $65.84	Professional	26	$28.02	$41.51	$65.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $52.49 / $105.94	Professional	TC	$16.89	$52.49	$105.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.29 / $76.87 / $205.31	Facility		$38.29	$76.87	$205.31
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $68.52 / $134.74 / $134.74	Facility	26	$68.52	$134.74	$134.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.04 / $83.66 / $459.15	Professional		$59.04	$83.66	$459.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.13 / $37.99 / $188.73	Professional	26	$25.13	$37.99	$188.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.58 / $46.89 / $313.58	Professional	TC	$28.58	$46.89	$313.58
United Facility/Professional Professional Modifier Low / Median / High Price $57.17 / $70.37 / $126.90	Professional		$57.17	$70.37	$126.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.04 / $33.35 / $55.10	Professional	26	$26.04	$33.35	$55.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $38.11 / $65.77	Professional	TC	$24.92	$38.11	$65.77