Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.53 / $313.02 / $626.04	Facility		$53.53	$313.02	$626.04
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 $225.60 / $340.47 / $667.40	Facility	TC	$225.60	$340.47	$667.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.23 / $34.40 / $65.50	Professional		$17.23	$34.40	$65.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $17.64 / $35.72	Professional	26	$7.50	$17.64	$35.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.07 / $46.15 / $55.27	Professional	TC	$21.07	$46.15	$55.27
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 $36.90 / $36.90 / $181.60	Facility		$36.90	$36.90	$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 $27.59 / $27.59 / $27.59	Facility	TC	$27.59	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.32 / $44.00 / $152.79	Professional		$26.32	$44.00	$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 $19.41 / $31.79 / $113.80	Professional	TC	$19.41	$31.79	$113.80
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.58 / $284.51 / $448.33	Facility		$114.58	$284.51	$448.33
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $91.55 / $268.02 / $388.00	Facility	TC	$91.55	$268.02	$388.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.64 / $56.40 / $86.20	Professional		$29.64	$56.40	$86.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.89 / $14.96 / $21.99	Professional	26	$12.89	$14.96	$21.99
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.27 / $44.27 / $44.27	Professional	TC	$44.27	$44.27	$44.27
United Facility/Professional Professional Modifier Low / Median / High Price $25.26 / $44.44 / $65.95	Professional		$25.26	$44.44	$65.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.30 / $10.56 / $20.93	Professional	26	$6.30	$10.56	$20.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $29.39 / $57.98	Professional	TC	$17.38	$29.39	$57.98