Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $436.52 / $1,047.13	Facility		$141.25	$436.52	$1,047.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $28.84 / $72.44	Facility	26	$20.42	$28.84	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $524.81	Professional		$117.49	$173.78	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $28.84 / $79.43	Professional	26	$19.95	$28.84	$79.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	52	$123.03	$123.03	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $131.83 / $263.03	Professional	TC	$97.72	$131.83	$263.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $346.74 / $891.25	Facility		$128.82	$346.74	$891.25
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $24.55 / $24.55	Facility	26	$24.55	$24.55	$24.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $169.82 / $309.03	Professional		$109.65	$169.82	$309.03
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $51.29	Professional	26	$19.50	$26.92	$51.29
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $141.25 / $269.15	Professional	TC	$95.50	$141.25	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $346.74 / $776.25	Facility		$134.90	$346.74	$776.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.13 / $27.54 / $66.07	Facility	26	$5.13	$27.54	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $380.19	Professional		$125.89	$199.53	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.90 / $60.26	Professional	26	$20.89	$30.90	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $173.78 / $323.59	Professional	TC	$107.15	$173.78	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $323.59 / $812.83	Facility		$29.51	$323.59	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $302.00	Professional		$117.49	$169.82	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.70 / $46.77	Professional	26	$19.05	$25.70	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $144.54 / $257.04	Professional	TC	$97.72	$144.54	$257.04