Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.75 / $256.33 / $369.54	Facility		$52.75	$256.33	$369.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.21 / $9.02 / $13.37	Facility	26	$8.21	$9.02	$13.37
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $174.84 / $308.32 / $389.16	Facility	TC	$174.84	$308.32	$389.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $32.19 / $68.95	Professional		$29.27	$32.19	$68.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $8.55 / $17.86	Professional	26	$7.50	$8.55	$17.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.07 / $24.03 / $48.22	Professional	TC	$21.07	$24.03	$48.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.06 / $28.39 / $44.18	Facility		$9.06	$28.39	$44.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.82 / $34.19 / $65.81	Professional		$11.82	$34.19	$65.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.53 / $36.53 / $181.60	Facility		$36.53	$36.53	$181.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.05 / $42.58 / $152.79	Professional		$26.05	$42.58	$152.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $12.19 / $40.40	Professional	26	$6.91	$12.19	$40.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $30.76 / $113.80	Professional	TC	$19.14	$30.76	$113.80
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.39 / $278.06 / $360.25	Facility		$116.39	$278.06	$360.25
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $119.88 / $246.81 / $402.24	Facility	TC	$119.88	$246.81	$402.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.08 / $55.83 / $85.25	Professional		$51.08	$55.83	$85.25
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $14.20 / $21.99	Professional	26	$8.84	$14.20	$21.99
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.67 / $43.67 / $43.67	Professional	TC	$43.67	$43.67	$43.67
United Facility/Professional Professional Modifier Low / Median / High Price $20.52 / $36.84 / $66.69	Professional		$20.52	$36.84	$66.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.60 / $10.18 / $20.56	Professional	26	$6.60	$10.18	$20.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.10 / $27.29 / $47.59	Professional	TC	$16.10	$27.29	$47.59