Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.43 / $14.27 / $23.19	Facility	26	$12.43	$14.27	$23.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.54 / $111.00 / $214.28	Professional		$75.54	$111.00	$214.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $12.93 / $33.88	Professional	26	$11.16	$12.93	$33.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.93 / $45.91 / $143.50	Professional	52	$37.93	$45.91	$143.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.66 / $103.19 / $152.96	Professional	TC	$66.66	$103.19	$152.96
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $13.79 / $13.79 / $13.79	Facility	26	$13.79	$13.79	$13.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.25 / $97.07 / $157.05	Professional		$79.25	$97.07	$157.05
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $13.66 / $22.82	Professional	26	$11.18	$13.66	$22.82
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.49 / $91.09 / $149.04	Professional	TC	$67.49	$91.09	$149.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.05 / $123.87 / $201.82	Professional		$81.05	$123.87	$201.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $16.89 / $28.79	Professional	26	$11.78	$16.89	$28.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.64 / $107.87 / $177.94	Professional	TC	$69.64	$107.87	$177.94
United Facility/Professional Professional Modifier Low / Median / High Price $80.93 / $113.93 / $202.36	Professional		$80.93	$113.93	$202.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.52 / $15.41 / $25.96	Professional	26	$11.52	$15.41	$25.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.40 / $105.01 / $170.73	Professional	TC	$71.40	$105.01	$170.73