Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.95 / $78.06 / $113.51	Facility	26	$70.95	$78.06	$113.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.39 / $412.19 / $522.50	Professional		$228.39	$412.19	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.06 / $126.78 / $150.91	Professional	26	$67.06	$126.78	$150.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $114.20 / $200.00 / $200.00	Professional	52	$114.20	$200.00	$200.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.41 / $306.76 / $368.50	Professional	TC	$157.41	$306.76	$368.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.53 / $230.33 / $466.93	Professional		$97.53	$230.33	$466.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.45 / $79.45 / $79.45	Facility	26	$79.45	$79.45	$79.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.16 / $512.15 / $2,080.44	Professional		$237.16	$512.15	$2,080.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.40 / $101.57 / $330.51	Professional	26	$60.40	$101.57	$330.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.13 / $441.27 / $1,541.05	Professional	TC	$139.13	$441.27	$1,541.05
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.11 / $150.44 / $184.41	Professional	26	$110.11	$150.44	$184.41
United Facility/Professional Professional Modifier Low / Median / High Price $216.54 / $565.41 / $1,297.11	Professional		$216.54	$565.41	$1,297.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.70 / $104.03 / $191.32	Professional	26	$49.70	$104.03	$191.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.85 / $390.48 / $829.11	Professional	TC	$150.85	$390.48	$829.11