Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $407.38 / $1,000.00	Facility		$37.15	$407.38	$1,000.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.47 / $11.48	Facility	26	$10.00	$10.47	$11.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.51 / $302.00 / $407.38	Facility	TC	$29.51	$302.00	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $42.66 / $102.33	Professional		$33.11	$42.66	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.59 / $26.30	Professional	26	$8.91	$12.59	$26.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $120.23 / $120.23 / $177.83	Professional	50	$120.23	$120.23	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $29.51 / $57.54	Professional	TC	$23.99	$29.51	$57.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $37.15 / $61.66	Facility		$12.88	$37.15	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $39.81 / $85.11	Professional		$14.13	$39.81	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $223.87	Facility		$64.57	$64.57	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.08 / $33.11 / $47.86	Facility	TC	$7.08	$33.11	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $54.95 / $194.98	Professional		$30.90	$54.95	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $15.49 / $50.12	Professional	26	$8.32	$15.49	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $38.90 / $144.54	Professional	TC	$22.39	$38.90	$144.54
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $426.58 / $977.24	Facility		$269.15	$426.58	$977.24
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $173.78 / $316.23 / $478.63	Facility	TC	$173.78	$316.23	$478.63
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $70.79 / $109.65	Professional		$70.79	$70.79	$109.65
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $27.54 / $28.18	Professional	26	$18.20	$27.54	$28.18
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $43.65 / $77.62	Professional		$30.20	$43.65	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.88 / $22.91	Professional	26	$8.32	$12.88	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $56.23	Professional	TC	$21.88	$30.20	$56.23