Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $425.00 / $522.50	Professional		$425.00	$425.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.50 / $127.50 / $154.00	Professional	26	$127.50	$127.50	$154.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $187.50 / $212.50 / $212.50	Professional	52	$187.50	$212.50	$212.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $297.50 / $297.50 / $368.50	Professional	TC	$297.50	$297.50	$368.50
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $395.69 / $395.69 / $395.69	Facility	26	$395.69	$395.69	$395.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $314.55 / $898.02 / $1,099.00	Professional		$314.55	$898.02	$1,099.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.62 / $84.62 / $271.89	Professional	26	$84.62	$84.62	$271.89
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $221.56 / $221.56 / $261.18	Professional	TC	$221.56	$221.56	$261.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.77 / $520.34 / $898.02	Professional		$310.77	$520.34	$898.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.37 / $95.29 / $271.89	Professional	26	$83.37	$95.29	$271.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.48 / $231.15 / $680.31	Professional	TC	$215.48	$231.15	$680.31
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $310.77 / $520.34 / $898.02	Professional		$310.77	$520.34	$898.02
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $88.31 / $95.29 / $271.89	Professional	26	$88.31	$95.29	$271.89
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $215.48 / $231.15 / $632.48	Professional	TC	$215.48	$231.15	$632.48
United Facility/Professional Professional Modifier Low / Median / High Price $256.85 / $490.45 / $878.47	Professional		$256.85	$490.45	$878.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.11 / $103.25 / $259.95	Professional	26	$65.11	$103.25	$259.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.13 / $341.96 / $690.67	Professional	TC	$163.13	$341.96	$690.67