Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.35 / $204.92 / $363.78	Facility		$51.35	$204.92	$363.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.19 / $10.19 / $12.71	Facility	26	$10.19	$10.19	$12.71
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $57.12 / $251.92 / $382.58	Facility	TC	$57.12	$251.92	$382.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.80 / $65.88 / $71.33	Professional		$29.80	$65.88	$71.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $21.38 / $22.73	Professional	26	$9.26	$21.38	$22.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $45.04 / $52.29	Professional	TC	$20.19	$45.04	$52.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.25 / $28.81 / $45.59	Facility		$11.25	$28.81	$45.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.67 / $33.43 / $68.28	Professional		$14.67	$33.43	$68.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.65 / $37.65 / $181.60	Facility		$37.65	$37.65	$181.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $26.10 / $26.10	Facility	TC	$26.10	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.94 / $44.60 / $157.47	Professional		$26.94	$44.60	$157.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $14.92 / $48.34	Professional	26	$8.58	$14.92	$48.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $29.51 / $109.12	Professional	TC	$18.36	$29.51	$109.12
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.37 / $335.84 / $482.10	Facility		$132.37	$335.84	$482.10
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $164.00 / $164.00 / $164.00	Facility	26	$164.00	$164.00	$164.00
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $92.95 / $256.04 / $377.00	Facility	TC	$92.95	$256.04	$377.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $87.29 / $88.85	Professional		$17.35	$87.29	$88.85
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $17.66 / $27.21	Professional	26	$15.98	$17.66	$27.21
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.88 / $41.88 / $57.54	Professional	TC	$41.88	$41.88	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $21.77 / $36.22 / $70.19	Professional		$21.77	$36.22	$70.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $15.85 / $83.06	Professional	26	$9.00	$15.85	$83.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.87 / $29.17 / $87.90	Professional	TC	$16.87	$29.17	$87.90