Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.66 / $158.26 / $158.26	Facility		$133.66	$158.26	$158.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.81 / $21.81 / $35.28	Facility	26	$21.81	$21.81	$35.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.81 / $178.25 / $267.54	Professional		$119.81	$178.25	$267.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.01 / $21.81 / $30.62	Professional	26	$20.01	$21.81	$30.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $59.20 / $66.84 / $71.73	Professional	52	$59.20	$66.84	$71.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.28 / $157.09 / $271.43	Professional	TC	$99.28	$157.09	$271.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.77 / $315.64 / $330.26	Professional		$255.77	$315.64	$330.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.42 / $51.12 / $53.61	Professional	26	$41.42	$51.12	$53.61
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $214.35 / $264.52 / $276.49	Professional	TC	$214.35	$264.52	$276.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.77 / $145.77 / $145.77	Facility		$145.77	$145.77	$145.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.72 / $24.72 / $24.72	Facility	26	$24.72	$24.72	$24.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.06 / $256.58 / $412.46	Professional		$144.06	$256.58	$412.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.01 / $41.63 / $63.29	Professional	26	$23.01	$41.63	$63.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.01 / $217.22 / $349.68	Professional	TC	$119.01	$217.22	$349.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $133.66 / $223.61 / $303.55	Facility		$133.66	$223.61	$303.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $152.71 / $260.69 / $1,173.20	Professional		$152.71	$260.69	$1,173.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $41.76 / $310.41	Professional	26	$22.74	$41.76	$310.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $128.33 / $219.08 / $1,048.79	Professional	TC	$128.33	$219.08	$1,048.79
United Facility/Professional Professional Modifier Low / Median / High Price $152.71 / $245.22 / $300.66	Professional		$152.71	$245.22	$300.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $39.83 / $51.51	Professional	26	$22.74	$39.83	$51.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.24 / $204.49 / $268.52	Professional	TC	$112.24	$204.49	$268.52