Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.33 / $280.14 / $296.25	Facility		$31.33	$280.14	$296.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.19 / $18.19 / $18.19	Facility	26	$18.19	$18.19	$18.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.14 / $249.25 / $265.05	Facility	TC	$13.14	$249.25	$265.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $31.33 / $80.15	Professional		$26.98	$31.33	$80.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.71 / $18.19 / $24.22	Professional	26	$14.71	$18.19	$24.22
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.49 / $15.67 / $19.02	Professional	52	$13.49	$15.67	$19.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.28 / $14.03 / $53.22	Professional	TC	$12.28	$14.03	$53.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.56 / $149.83 / $217.04	Facility		$111.56	$149.83	$217.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.30 / $36.75 / $50.46	Professional		$20.30	$36.75	$50.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.02 / $75.02 / $99.72	Facility		$75.02	$75.02	$99.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.30 / $27.30 / $34.45	Facility	26	$27.30	$27.30	$34.45
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $47.72 / $47.72 / $65.27	Facility	TC	$47.72	$47.72	$65.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $71.45 / $108.78	Professional		$42.98	$71.45	$108.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.90 / $28.54 / $36.61	Professional	26	$21.90	$28.54	$36.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $39.27 / $73.02	Professional	TC	$18.32	$39.27	$73.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.33 / $58.48 / $127.54	Facility		$31.33	$58.48	$127.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $47.60 / $100.00 / $100.00	Facility	26	$47.60	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $52.28 / $141.03 / $141.03	Facility	TC	$52.28	$141.03	$141.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $72.42 / $402.37	Professional		$39.86	$72.42	$402.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.14 / $25.65 / $130.60	Professional	26	$19.14	$25.65	$130.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.72 / $46.40 / $284.52	Professional	TC	$20.72	$46.40	$284.52
United Facility/Professional Professional Modifier Low / Median / High Price $38.96 / $56.69 / $91.00	Professional		$38.96	$56.69	$91.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.14 / $23.11 / $36.85	Professional	26	$19.14	$23.11	$36.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.25 / $32.11 / $60.50	Professional	TC	$20.25	$32.11	$60.50