Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.45 / $12.45 / $20.10	Facility	26	$12.45	$12.45	$20.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.63 / $56.38 / $129.55	Professional		$52.63	$56.38	$129.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $12.45 / $34.01	Professional	26	$11.24	$12.45	$34.01
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.12 / $28.49 / $31.38	Professional	52	$25.12	$28.49	$31.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.10 / $45.18 / $115.06	Professional	TC	$41.10	$45.18	$115.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $137.94 / $144.18	Professional		$111.78	$137.94	$144.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.01 / $28.40 / $29.69	Professional	26	$23.01	$28.40	$29.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.76 / $109.54 / $114.50	Professional	TC	$88.76	$109.54	$114.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.94 / $118.74 / $183.27	Professional		$66.94	$118.74	$183.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.55 / $23.61 / $36.44	Professional	26	$15.55	$23.61	$36.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.72 / $95.13 / $146.83	Professional	TC	$52.72	$95.13	$146.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $27.92 / $80.00	Facility	26	$27.92	$27.92	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.36 / $95.67 / $346.85	Professional		$54.36	$95.67	$346.85
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.61 / $23.43 / $45.30	Professional	26	$13.61	$23.43	$45.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $41.87 / $73.34 / $272.27	Professional	TC	$41.87	$73.34	$272.27
United Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $90.36 / $159.46	Professional		$54.35	$90.36	$159.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $21.08 / $32.09	Professional	26	$12.23	$21.08	$32.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.87 / $68.62 / $92.77	Professional	TC	$41.87	$68.62	$92.77