Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.46 / $45.46 / $45.46	Facility		$45.46	$45.46	$45.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.83 / $21.83 / $21.83	Facility	26	$21.83	$21.83	$21.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.63 / $294.72 / $294.72	Facility	TC	$23.63	$294.72	$294.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.49 / $71.09 / $177.11	Professional		$33.49	$71.09	$177.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.18 / $22.01 / $51.25	Professional	26	$19.18	$22.01	$51.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.30 / $20.68 / $40.08	Professional	52	$14.30	$20.68	$40.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.38 / $28.14 / $97.50	Professional	TC	$13.38	$28.14	$97.50
BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.33 / $89.26 / $93.61	Professional		$72.33	$89.26	$93.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $49.49 / $51.74	Professional	26	$40.11	$49.49	$51.74
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $39.76 / $41.69	Professional	TC	$32.22	$39.76	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $41.38 / $41.38	Facility		$41.38	$41.38	$41.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $18.64	Facility	TC	$18.64	$18.64	$18.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.12 / $80.92 / $123.65	Professional		$43.12	$80.92	$123.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.77 / $37.68 / $61.47	Professional	26	$21.77	$37.68	$61.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $43.37 / $79.80	Professional	TC	$20.35	$43.37	$79.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.46 / $63.59 / $132.37	Facility		$45.46	$63.59	$132.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $112.93 / $402.37	Professional		$56.73	$112.93	$402.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.28 / $44.18 / $130.60	Professional	26	$22.28	$44.18	$130.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $75.38 / $284.52	Professional	TC	$29.49	$75.38	$284.52
United Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $87.83 / $132.86	Professional		$45.83	$87.83	$132.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.01 / $39.76 / $51.86	Professional	26	$22.01	$39.76	$51.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $52.54 / $88.68	Professional	TC	$23.82	$52.54	$88.68