Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $630.96 / $794.33	Facility		$251.19	$630.96	$794.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $42.66 / $67.61	Facility	26	$41.69	$42.66	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $309.03	Professional		$147.91	$177.83	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $141.25	Professional	26	$38.90	$51.29	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $125.89 / $223.87	Professional	TC	$109.65	$125.89	$223.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $295.12 / $331.13	Professional		$223.87	$295.12	$331.13
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $89.13 / $97.72	Professional	26	$67.61	$89.13	$97.72
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $208.93 / $229.09	Professional	TC	$158.49	$208.93	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $354.81	Professional		$173.78	$281.84	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $77.62 / $100.00	Professional	26	$47.86	$77.62	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $190.55 / $239.88	Professional	TC	$125.89	$190.55	$239.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $223.87 / $295.12	Facility		$169.82	$223.87	$295.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $323.59 / $1,023.29	Professional		$199.53	$323.59	$1,023.29
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $263.03	Professional	26	$57.54	$89.13	$263.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $229.09 / $776.25	Professional	TC	$141.25	$229.09	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $407.38	Professional		$199.53	$309.03	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $81.28 / $104.71	Professional	26	$53.70	$81.28	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $223.87 / $302.00	Professional	TC	$141.25	$223.87	$302.00