Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $128.82 / $208.93	Facility	26	$123.03	$128.82	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $676.08 / $1,096.48	Professional		$562.34	$676.08	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $204.17 / $467.74	Professional	26	$114.82	$204.17	$467.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $245.47 / $269.15 / $275.42	Professional	52	$245.47	$269.15	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $549.54 / $891.25	Professional	TC	$446.68	$549.54	$891.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,445.44 / $1,621.81	Professional		$1,096.48	$1,445.44	$1,621.81
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $204.17 / $269.15 / $295.12	Professional	26	$204.17	$269.15	$295.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $891.25 / $1,174.90 / $1,318.26	Professional	TC	$891.25	$1,174.90	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,318.26 / $1,621.81	Professional		$724.44	$1,318.26	$1,621.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $234.42 / $295.12	Professional	26	$144.54	$234.42	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $549.54 / $1,071.52 / $1,348.96	Professional	TC	$549.54	$1,071.52	$1,348.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $1,174.90 / $6,165.95	Professional		$707.95	$1,174.90	$6,165.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $229.09 / $2,570.40	Professional	26	$154.88	$229.09	$2,570.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $562.34 / $912.01 / $7,079.46	Professional	TC	$562.34	$912.01	$7,079.46
United Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,122.02 / $1,621.81	Professional		$691.83	$1,122.02	$1,621.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $223.87 / $316.23	Professional	26	$138.04	$223.87	$316.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $549.54 / $912.01 / $1,318.26	Professional	TC	$549.54	$912.01	$1,318.26