Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $439.26 / $1,083.00 / $2,812.00	Facility		$439.26	$1,083.00	$2,812.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.78 / $171.91 / $257.87	Facility	26	$158.78	$171.91	$257.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.94 / $439.26 / $464.25	Professional		$302.94	$439.26	$464.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.10 / $171.91 / $171.91	Professional	26	$116.10	$171.91	$171.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.84 / $267.36 / $310.62	Professional	TC	$186.84	$267.36	$310.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.99 / $635.99 / $763.19	Facility		$635.99	$635.99	$763.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.47 / $458.56 / $458.56	Professional		$346.47	$458.56	$458.56
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.99 / $152.19 / $152.19	Professional	26	$114.99	$152.19	$152.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $231.48 / $306.37 / $306.37	Professional	TC	$231.48	$306.37	$306.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $276.99 / $455.53 / $732.53	Professional		$276.99	$455.53	$732.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $304.89 / $304.89 / $304.89	Facility		$304.89	$304.89	$304.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.49 / $564.28 / $704.80	Professional		$441.49	$564.28	$704.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $175.41 / $220.50 / $271.61	Professional	26	$175.41	$220.50	$271.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $264.30 / $353.24 / $467.04	Professional	TC	$264.30	$353.24	$467.04
United Facility/Professional Facility Modifier Low / Median / High Price $330.00 / $827.00 / $2,285.00	Facility		$330.00	$827.00	$2,285.00
United Facility/Professional Professional Modifier Low / Median / High Price $306.23 / $385.08 / $681.46	Professional		$306.23	$385.08	$681.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.03 / $139.69 / $246.72	Professional	26	$117.03	$139.69	$246.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $182.61 / $264.30 / $446.48	Professional	TC	$182.61	$264.30	$446.48