Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Facility		$275.42	$275.42	$275.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $275.42 / $275.42 / $275.42	Facility	TC	$275.42	$275.42	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $57.54 / $128.82	Professional		$33.11	$57.54	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $26.30 / $51.29	Professional	26	$18.20	$26.30	$51.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	52	$87.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $23.99 / $56.23	Professional	TC	$12.88	$23.99	$56.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $67.61 / $67.61	Professional		$53.70	$67.61	$67.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $37.15 / $37.15	Professional	26	$30.20	$37.15	$37.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $30.20 / $30.20	Professional	TC	$23.99	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $100.00 / $208.93	Professional		$58.88	$100.00	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $37.15 / $67.61	Professional	26	$21.88	$37.15	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $64.57 / $151.36	Professional	TC	$28.18	$64.57	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $204.17	Professional		$66.07	$89.13	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $38.90 / $69.18	Professional	26	$22.39	$38.90	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $54.95 / $134.90	Professional	TC	$31.62	$54.95	$134.90