Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.22 / $249.51 / $424.98	Facility		$90.22	$249.51	$424.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.07 / $67.54 / $112.02	Facility	26	$51.07	$67.54	$112.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $212.06 / $460.83	Professional		$66.34	$212.06	$460.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.02 / $65.01 / $121.39	Professional	26	$37.02	$65.01	$121.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.28 / $47.83 / $184.25	Professional	TC	$28.28	$47.83	$184.25
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.90 / $147.90 / $177.48	Facility		$147.90	$147.90	$177.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.50 / $85.37 / $85.37	Professional		$64.50	$85.37	$85.37
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.28 / $49.34 / $49.34	Professional	26	$37.28	$49.34	$49.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.22 / $36.03 / $36.03	Professional	TC	$27.22	$36.03	$36.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $31.81 / $52.00 / $94.92	Facility		$31.81	$52.00	$94.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $41.94 / $81.12	Professional		$30.76	$41.94	$81.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.57 / $110.57 / $110.57	Facility		$110.57	$110.57	$110.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.22 / $140.66 / $297.49	Professional		$91.22	$140.66	$297.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.39 / $81.61 / $122.74	Professional	26	$54.39	$81.61	$122.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.42 / $49.22 / $191.99	Professional	TC	$35.42	$49.22	$191.99
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $345.00 / $768.00	Facility		$130.00	$345.00	$768.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $124.65 / $287.89	Professional		$60.28	$124.65	$287.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $72.37 / $117.27	Professional	26	$34.54	$72.37	$117.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.30 / $49.66 / $175.68	Professional	TC	$25.30	$49.66	$175.68