Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $425.00 / $576.29	Professional		$425.00	$425.00	$576.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.50 / $127.50 / $154.00	Professional	26	$112.50	$127.50	$154.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $187.50 / $212.50 / $212.50	Professional	52	$187.50	$212.50	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $297.50 / $477.24	Professional	TC	$297.50	$297.50	$477.24
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $432.84 / $432.84 / $432.84	Facility	26	$432.84	$432.84	$432.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $305.12 / $359.67 / $1,099.00	Professional		$305.12	$359.67	$1,099.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.21 / $93.21 / $295.58	Professional	26	$93.21	$93.21	$295.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.38 / $204.38 / $240.91	Professional	TC	$204.38	$204.38	$240.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.73 / $504.85 / $867.40	Professional		$299.73	$504.85	$867.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.66 / $103.66 / $295.58	Professional	26	$91.66	$103.66	$295.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.06 / $215.06 / $670.78	Professional	TC	$196.06	$215.06	$670.78
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $299.73 / $504.85 / $867.40	Professional		$299.73	$504.85	$867.40
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $96.44 / $103.66 / $295.58	Professional	26	$96.44	$103.66	$295.58
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $196.06 / $215.06 / $669.91	Professional	TC	$196.06	$215.06	$669.91
United Facility/Professional Professional Modifier Low / Median / High Price $219.70 / $473.72 / $922.68	Professional		$219.70	$473.72	$922.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.34 / $105.14 / $314.42	Professional	26	$72.34	$105.14	$314.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.49 / $312.29 / $731.54	Professional	TC	$150.49	$312.29	$731.54