Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $425.00 / $577.29	Professional		$425.00	$425.00	$577.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.50 / $127.50 / $154.00	Professional	26	$112.50	$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 / $477.24	Professional	TC	$297.50	$297.50	$477.24
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $433.83 / $433.83 / $433.83	Facility	26	$433.83	$433.83	$433.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $268.94 / $845.95 / $1,099.00	Professional		$268.94	$845.95	$1,099.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.21 / $93.21 / $295.58	Professional	26	$93.21	$93.21	$295.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $175.73 / $175.73 / $201.11	Professional	TC	$175.73	$175.73	$201.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.66 / $492.22 / $845.95	Professional		$291.66	$492.22	$845.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.66 / $104.17 / $295.58	Professional	26	$91.66	$104.17	$295.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $204.22 / $640.57	Professional	TC	$187.50	$204.22	$640.57
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $291.66 / $492.22 / $845.95	Professional		$291.66	$492.22	$845.95
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 $187.50 / $204.22 / $611.72	Professional	TC	$187.50	$204.22	$611.72
United Facility/Professional Professional Modifier Low / Median / High Price $242.96 / $462.01 / $899.87	Professional		$242.96	$462.01	$899.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.34 / $105.14 / $314.42	Professional	26	$72.34	$105.14	$314.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.72 / $300.58 / $668.01	Professional	TC	$144.72	$300.58	$668.01