Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.71 / $1,070.00 / $2,812.00	Facility		$163.71	$1,070.00	$2,812.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.22 / $54.74 / $110.81	Facility	26	$52.22	$54.74	$110.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.41 / $145.56 / $288.98	Professional		$134.41	$145.56	$288.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.25 / $54.74 / $57.97	Professional	26	$40.25	$54.74	$57.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.81 / $90.82 / $181.57	Professional	TC	$90.81	$90.82	$181.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.51 / $217.73 / $217.73	Professional		$164.51	$217.73	$217.73
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.24 / $46.64 / $46.64	Professional	26	$35.24	$46.64	$46.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $129.27 / $171.09 / $171.09	Professional	TC	$129.27	$171.09	$171.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.89 / $159.35 / $215.24	Facility		$55.89	$159.35	$215.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.39 / $140.50 / $246.28	Professional		$47.39	$140.50	$246.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.78 / $203.78 / $203.78	Facility		$203.78	$203.78	$203.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.30 / $235.09 / $348.67	Professional		$144.30	$235.09	$348.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.43 / $70.23 / $90.34	Professional	26	$55.43	$70.23	$90.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.87 / $162.21 / $273.17	Professional	TC	$88.87	$162.21	$273.17
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $337.00 / $858.00	Facility		$130.00	$337.00	$858.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.41 / $176.92 / $352.07	Professional		$131.41	$176.92	$352.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $44.30 / $83.92	Professional	26	$37.11	$44.30	$83.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.91 / $128.24 / $268.41	Professional	TC	$90.91	$128.24	$268.41