Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.52 / $254.74 / $466.24	Facility		$78.52	$254.74	$466.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.49 / $10.49 / $13.07	Facility	26	$10.49	$10.49	$13.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $64.20 / $279.18 / $617.58	Facility	TC	$64.20	$279.18	$617.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.01 / $42.03 / $93.62	Professional		$22.01	$42.03	$93.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $17.87 / $23.29	Professional	26	$10.02	$17.87	$23.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.01 / $53.01 / $53.01	Professional	50	$53.01	$53.01	$53.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.60 / $69.22 / $75.00	Professional	TC	$29.60	$69.22	$75.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.57 / $41.16 / $64.28	Facility		$11.57	$41.16	$64.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $51.98 / $95.43	Professional		$15.09	$51.98	$95.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.31 / $53.31 / $181.60	Facility		$53.31	$53.31	$181.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.38 / $41.38 / $41.38	Facility	TC	$41.38	$41.38	$41.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.99 / $57.74 / $222.97	Professional		$34.99	$57.74	$222.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $15.39 / $49.89	Professional	26	$8.85	$15.39	$49.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $45.62 / $173.04	Professional	TC	$29.11	$45.62	$173.04
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.59 / $316.18 / $442.72	Facility		$132.59	$316.18	$442.72
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $159.69 / $268.63 / $388.00	Facility	TC	$159.69	$268.63	$388.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.84 / $78.01 / $126.53	Professional		$72.84	$78.01	$126.53
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.68 / $22.79 / $28.08	Professional	26	$16.68	$22.79	$28.08
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $80.98 / $80.98 / $81.47	Professional	50	$80.98	$80.98	$81.47
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.86 / $57.86 / $66.41	Professional	TC	$57.86	$57.86	$66.41
United Facility/Professional Professional Modifier Low / Median / High Price $34.63 / $52.76 / $95.65	Professional		$34.63	$52.76	$95.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.05 / $14.53 / $26.25	Professional	26	$8.05	$14.53	$26.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.19 / $33.60 / $67.63	Professional	TC	$25.19	$33.60	$67.63