Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.66 / $314.89 / $667.40	Facility		$88.66	$314.89	$667.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.87 / $8.65 / $9.82	Facility	26	$7.87	$8.65	$9.82
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $128.82 / $332.76 / $667.40	Facility	TC	$128.82	$332.76	$667.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.91 / $35.06 / $100.52	Professional		$16.91	$35.06	$100.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.56 / $17.19 / $34.61	Professional	26	$7.56	$17.19	$34.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.00 / $70.00 / $135.25	Professional	50	$67.00	$70.00	$135.25
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.34 / $16.61 / $18.04	Professional	52	$15.34	$16.61	$18.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $50.43 / $100.52	Professional	TC	$22.05	$50.43	$100.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $29.46 / $45.90	Facility		$8.69	$29.46	$45.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.34 / $36.53 / $68.31	Professional		$11.34	$36.53	$68.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.40 / $38.40 / $181.60	Facility		$38.40	$38.40	$181.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $29.46	Facility	TC	$29.46	$29.46	$29.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.35 / $42.22 / $159.01	Professional		$27.35	$42.22	$159.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $12.19 / $42.25	Professional	26	$6.62	$12.19	$42.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $32.85 / $121.61	Professional	TC	$19.57	$32.85	$121.61
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.31 / $354.89 / $537.00	Facility		$188.31	$354.89	$537.00
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $159.07 / $267.12 / $378.84	Facility	TC	$159.07	$267.12	$378.84
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.72 / $89.02 / $91.13	Professional		$30.72	$89.02	$91.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.51 / $17.09 / $21.23	Professional	26	$12.51	$17.09	$21.23
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.72 / $41.72 / $41.72	Professional	TC	$41.72	$41.72	$41.72
United Facility/Professional Professional Modifier Low / Median / High Price $22.81 / $39.53 / $67.84	Professional		$22.81	$39.53	$67.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $11.79 / $63.77	Professional	26	$6.96	$11.79	$63.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.21 / $27.26 / $43.38	Professional	TC	$16.21	$27.26	$43.38