Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $68.75 / $68.75	Facility	26	$62.50	$68.75	$68.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.77 / $225.05 / $427.97	Professional		$195.77	$225.05	$427.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.60 / $62.95 / $128.03	Professional	26	$52.60	$62.95	$128.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.80 / $162.27 / $358.73	Professional	TC	$136.80	$162.27	$358.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.36 / $198.08 / $401.72	Professional		$83.36	$198.08	$401.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.54	Facility	26	$67.54	$67.54	$67.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.35 / $433.44 / $1,709.52	Professional		$200.35	$433.44	$1,709.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.33 / $96.19 / $315.83	Professional	26	$51.33	$96.19	$315.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.14 / $329.53 / $1,110.02	Professional	TC	$119.14	$329.53	$1,110.02
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.54 / $155.10 / $158.78	Professional	26	$93.54	$155.10	$158.78
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.97 / $251.97 / $251.97	Professional	TC	$251.97	$251.97	$251.97
United Facility/Professional Professional Modifier Low / Median / High Price $182.76 / $355.72 / $810.99	Professional		$182.76	$355.72	$810.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $86.41 / $160.46	Professional	26	$41.11	$86.41	$160.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.61 / $333.20 / $635.53	Professional	TC	$127.61	$333.20	$635.53