Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $125.89	Facility	26	$72.44	$72.44	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $426.58 / $977.24	Professional		$194.98	$426.58	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $134.90 / $208.93	Professional	26	$66.07	$134.90	$208.93
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $870.96 / $870.96 / $870.96	Professional	52	$870.96	$870.96	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $245.47 / $489.78	Professional	TC	$123.03	$245.47	$489.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $169.82 / $407.38	Professional		$91.20	$169.82	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $501.19 / $2,187.76	Professional		$165.96	$501.19	$2,187.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $100.00 / $380.19	Professional	26	$52.48	$100.00	$380.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $302.00 / $1,445.44	Professional	TC	$104.71	$302.00	$1,445.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $120.23 / $190.55	Professional	26	$112.20	$120.23	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $371.54 / $870.96	Professional		$173.78	$371.54	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $85.11 / $151.36	Professional	26	$44.67	$85.11	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $245.47 / $724.44	Professional	TC	$107.15	$245.47	$724.44