Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.68 / $78.84 / $115.91	Facility	26	$71.68	$78.84	$115.91
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.85 / $38.85 / $49.04	Facility	53	$38.85	$38.85	$49.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.27 / $400.00 / $522.50	Professional		$194.27	$400.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.63 / $147.34 / $153.85	Professional	26	$66.63	$147.34	$153.85
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.14 / $200.00 / $200.00	Professional	52	$97.14	$200.00	$200.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.60 / $281.41 / $368.50	Professional	TC	$122.60	$281.41	$368.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $98.51 / $192.19 / $405.10	Professional		$98.51	$192.19	$405.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $45.11 / $45.11 / $45.11	Facility	53	$45.11	$45.11	$45.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.69 / $489.20 / $2,107.96	Professional		$179.69	$489.20	$2,107.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.00 / $103.57 / $339.71	Professional	26	$61.00	$103.57	$339.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.25 / $305.33 / $1,559.26	Professional	TC	$110.25	$305.33	$1,559.26
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $111.17 / $151.88 / $187.58	Professional	26	$111.17	$151.88	$187.58
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $243.53 / $243.53 / $243.53	Professional	TC	$243.53	$243.53	$243.53
United Facility/Professional Professional Modifier Low / Median / High Price $182.95 / $464.11 / $1,071.13	Professional		$182.95	$464.11	$1,071.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.41 / $89.88 / $173.95	Professional	26	$44.41	$89.88	$173.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.33 / $327.14 / $837.63	Professional	TC	$116.33	$327.14	$837.63