Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $204.17 / $389.05	Facility		$45.71	$204.17	$389.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.23 / $11.22	Facility	26	$10.00	$10.23	$11.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $57.54 / $251.19 / $389.05	Facility	TC	$57.54	$251.19	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $45.71 / $97.72	Professional		$26.92	$45.71	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.72 / $30.90	Professional	26	$7.94	$10.72	$30.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $41.69 / $53.70	Professional	TC	$19.05	$41.69	$53.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $29.51 / $50.12	Facility		$12.59	$29.51	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $31.62 / $70.79	Professional		$13.80	$31.62	$70.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $52.48 / $181.97	Facility		$52.48	$52.48	$181.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.37 / $25.12 / $36.31	Facility	TC	$5.37	$25.12	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $44.67 / $158.49	Professional		$25.12	$44.67	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.79 / $47.86	Professional	26	$7.94	$14.79	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $27.54 / $109.65	Professional	TC	$16.98	$27.54	$109.65
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $363.08 / $501.19	Facility		$131.83	$363.08	$501.19
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $239.88 / $239.88	Facility	26	$239.88	$239.88	$239.88
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $93.33 / $257.04 / $380.19	Facility	TC	$93.33	$257.04	$380.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $87.10 / $89.13	Professional		$7.94	$87.10	$89.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $17.38 / $27.54	Professional	26	$15.85	$17.38	$27.54
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	TC	$41.69	$41.69	$41.69
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $34.67 / $63.10	Professional		$23.44	$34.67	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.30 / $22.39	Professional	26	$7.76	$12.30	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.88 / $41.69	Professional	TC	$15.85	$21.88	$41.69