Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.50 / $332.76 / $665.52	Facility		$78.50	$332.76	$665.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.83 / $9.72 / $302.00	Facility	26	$8.83	$9.72	$302.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $227.03 / $409.84 / $778.32	Facility	TC	$227.03	$409.84	$778.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $39.52 / $130.00	Professional		$19.00	$39.52	$130.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $19.17 / $39.15	Professional	26	$8.56	$19.17	$39.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.15 / $65.31 / $162.12	Professional	50	$38.15	$65.31	$162.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.30 / $19.70 / $21.60	Professional	52	$18.30	$19.70	$21.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.36 / $60.37 / $70.22	Professional	TC	$27.36	$60.37	$70.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.75 / $35.13 / $54.83	Facility		$9.75	$35.13	$54.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.72 / $44.48 / $81.45	Professional		$12.72	$44.48	$81.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.85 / $45.85 / $181.60	Facility		$45.85	$45.85	$181.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.79 / $35.79 / $35.79	Facility	TC	$35.79	$35.79	$35.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.47 / $50.45 / $190.20	Professional		$31.47	$50.45	$190.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $13.15 / $42.25	Professional	26	$7.45	$13.15	$42.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.65 / $39.96 / $148.12	Professional	TC	$22.65	$39.96	$148.12
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.82 / $323.82 / $477.37	Facility		$115.82	$323.82	$477.37
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $162.29 / $273.77 / $371.17	Facility	TC	$162.29	$273.77	$371.17
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.51 / $106.22 / $108.82	Professional		$66.51	$106.22	$108.82
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.75 / $21.27 / $23.82	Professional	26	$13.75	$21.27	$23.82
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.69 / $57.43 / $70.06	Professional	TC	$54.69	$57.43	$70.06
United Facility/Professional Professional Modifier Low / Median / High Price $23.65 / $37.49 / $79.88	Professional		$23.65	$37.49	$79.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $10.98 / $22.14	Professional	26	$7.18	$10.98	$22.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $33.44 / $55.57	Professional	TC	$21.32	$33.44	$55.57