Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $425.00 / $522.50	Professional		$425.00	$425.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.50 / $127.50 / $154.00	Professional	26	$127.50	$127.50	$154.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $187.50 / $212.50 / $212.50	Professional	52	$187.50	$212.50	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $297.50 / $368.50	Professional	TC	$297.50	$297.50	$368.50
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $467.81 / $467.81 / $467.81	Facility	26	$467.81	$467.81	$467.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.91 / $843.11 / $1,099.00	Professional		$289.91	$843.11	$1,099.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.65 / $100.65 / $295.58	Professional	26	$100.65	$100.65	$295.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $189.26 / $189.26 / $216.60	Professional	TC	$189.26	$189.26	$216.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.66 / $491.41 / $843.11	Professional		$290.66	$491.41	$843.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.44 / $104.17 / $295.58	Professional	26	$96.44	$104.17	$295.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.49 / $205.70 / $617.77	Professional	TC	$186.49	$205.70	$617.77
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $290.66 / $491.41 / $843.11	Professional		$290.66	$491.41	$843.11
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $96.44 / $104.17 / $295.58	Professional	26	$96.44	$104.17	$295.58
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $186.49 / $205.70 / $594.99	Professional	TC	$186.49	$205.70	$594.99
United Facility/Professional Professional Modifier Low / Median / High Price $220.51 / $460.46 / $896.85	Professional		$220.51	$460.46	$896.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.12 / $105.14 / $281.63	Professional	26	$77.12	$105.14	$281.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.36 / $299.02 / $649.74	Professional	TC	$144.36	$299.02	$649.74