Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.03 / $193.56 / $665.52	Facility		$49.03	$193.56	$665.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.49 / $562.12 / $562.12	Facility	26	$10.49	$562.12	$562.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $177.66 / $366.68 / $606.29	Facility	TC	$177.66	$366.68	$606.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.92 / $40.90 / $77.56	Professional		$35.92	$40.90	$77.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $22.12 / $23.29	Professional	26	$10.02	$22.12	$23.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $33.17 / $65.75	Professional	TC	$25.43	$33.17	$65.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.57 / $34.47 / $53.67	Facility		$11.57	$34.47	$53.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $40.74 / $79.92	Professional		$15.09	$40.74	$79.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.74 / $44.74 / $223.40	Facility		$44.74	$44.74	$223.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.30 / $50.66 / $115.32	Professional		$29.30	$50.66	$115.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $15.59 / $51.42	Professional	26	$8.85	$15.59	$51.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $36.61 / $135.63	Professional	TC	$23.08	$36.61	$135.63
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.54 / $360.25 / $568.27	Facility		$131.54	$360.25	$568.27
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $157.80 / $301.13 / $495.48	Facility	TC	$157.80	$301.13	$495.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.55 / $103.52 / $106.17	Professional		$62.55	$103.52	$106.17
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.68 / $19.14 / $28.14	Professional	26	$16.68	$19.14	$28.14
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.87 / $45.87 / $52.64	Professional	TC	$45.87	$45.87	$52.64
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $43.71 / $81.09	Professional		$26.92	$43.71	$81.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $12.93 / $23.76	Professional	26	$7.93	$12.93	$23.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $32.47 / $61.97	Professional	TC	$19.88	$32.47	$61.97