Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.78 / $44.95 / $585.05	Facility		$40.78	$44.95	$585.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.49 / $11.53 / $13.07	Facility	26	$10.49	$11.53	$13.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $67.38 / $300.80 / $407.02	Facility	TC	$67.38	$300.80	$407.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $39.88 / $74.08	Professional		$35.95	$39.88	$74.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $11.61 / $23.04	Professional	26	$9.59	$11.61	$23.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $30.22 / $57.56	Professional	TC	$25.57	$30.22	$57.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.57 / $35.86 / $55.88	Facility		$11.57	$35.86	$55.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.09 / $43.08 / $83.14	Professional		$15.09	$43.08	$83.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.23 / $46.23 / $223.40	Facility		$46.23	$46.23	$223.40
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 $34.29 / $34.29 / $34.29	Facility	TC	$34.29	$34.29	$34.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $55.58 / $193.33	Professional		$32.97	$55.58	$193.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $15.81 / $49.89	Professional	26	$8.85	$15.81	$49.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.13 / $38.71 / $143.44	Professional	TC	$24.13	$38.71	$143.44
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $313.73 / $393.53 / $982.45	Facility		$313.73	$393.53	$982.45
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $181.29 / $313.45 / $477.55	Facility	TC	$181.29	$313.45	$477.55
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.64 / $70.64 / $109.06	Professional		$70.64	$70.64	$109.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.12 / $27.75 / $28.23	Professional	26	$18.12	$27.75	$28.23
United Facility/Professional Professional Modifier Low / Median / High Price $32.45 / $46.15 / $84.74	Professional		$32.45	$46.15	$84.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $15.01 / $26.25	Professional	26	$9.15	$15.01	$26.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $29.98 / $58.49	Professional	TC	$22.40	$29.98	$58.49