Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $288.40 / $660.69	Facility		$63.10	$288.40	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $8.13 / $13.49	Facility	26	$8.13	$8.13	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $61.66 / $331.13 / $691.83	Facility	TC	$61.66	$331.13	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $35.48 / $102.33	Professional		$8.71	$35.48	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $17.38 / $38.90	Professional	26	$7.41	$17.38	$38.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.12 / $69.18 / $218.78	Professional	50	$25.12	$69.18	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $42.66 / $72.44	Professional	TC	$22.91	$42.66	$72.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $34.67 / $54.95	Facility		$10.23	$34.67	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $36.31 / $77.62	Professional		$10.96	$36.31	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $181.97	Facility		$57.54	$57.54	$181.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	TC	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $48.98 / $173.78	Professional		$27.54	$48.98	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $12.02 / $41.69	Professional	26	$6.46	$12.02	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $39.81 / $134.90	Professional	TC	$20.42	$39.81	$134.90
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $316.23 / $457.09	Facility		$114.82	$316.23	$457.09
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $95.50 / $251.19 / $371.54	Facility	TC	$95.50	$251.19	$371.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $97.72 / $97.72	Professional		$60.26	$97.72	$97.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.42 / $21.88	Professional	26	$12.88	$20.42	$21.88
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $83.18 / $97.72	Professional	TC	$51.29	$83.18	$97.72
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $67.61	Professional		$22.91	$34.67	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $10.00 / $18.20	Professional	26	$6.17	$10.00	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $48.98	Professional	TC	$16.98	$25.12	$48.98