Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.44 / $338.40 / $667.40	Facility		$165.44	$338.40	$667.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.87 / $8.65 / $12.32	Facility	26	$7.87	$8.65	$12.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $219.96 / $341.22 / $691.84	Facility	TC	$219.96	$341.22	$691.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.01 / $30.26 / $62.57	Professional		$17.01	$30.26	$62.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $17.12 / $34.38	Professional	26	$7.22	$17.12	$34.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.12 / $56.12 / $56.12	Professional	50	$56.12	$56.12	$56.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.03 / $15.13 / $16.61	Professional	52	$14.03	$15.13	$16.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $38.27 / $92.38	Professional	TC	$20.19	$38.27	$92.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $27.23 / $42.36	Facility		$8.69	$27.23	$42.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.34 / $32.79 / $63.13	Professional		$11.34	$32.79	$63.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $35.40 / $223.40	Facility		$35.40	$35.40	$223.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.47 / $26.47 / $26.47	Facility	TC	$26.47	$26.47	$26.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.25 / $39.79 / $146.58	Professional		$25.25	$39.79	$146.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $11.50 / $38.57	Professional	26	$6.62	$11.50	$38.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $29.51 / $109.12	Professional	TC	$18.48	$29.51	$109.12
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.06 / $372.18 / $485.81	Facility		$94.06	$372.18	$485.81
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $138.96 / $267.12 / $426.60	Facility	TC	$138.96	$267.12	$426.60
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.12 / $54.12 / $83.08	Professional		$54.12	$54.12	$83.08
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $20.74 / $27.34	Professional	26	$13.09	$20.74	$27.34
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $99.04 / $99.04 / $99.04	Professional	50	$99.04	$99.04	$99.04
United Facility/Professional Professional Modifier Low / Median / High Price $18.53 / $32.74 / $62.54	Professional		$18.53	$32.74	$62.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.77 / $19.72	Professional	26	$6.03	$9.77	$19.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.36 / $19.13 / $41.77	Professional	TC	$13.36	$19.13	$41.77