Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $332.76 / $687.52	Facility		$63.00	$332.76	$687.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.21 / $9.02 / $13.37	Facility	26	$8.21	$9.02	$13.37
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $191.76 / $331.82 / $689.96	Facility	TC	$191.76	$331.82	$689.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.86 / $36.36 / $77.31	Professional		$17.86	$36.36	$77.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $17.85 / $36.10	Professional	26	$7.78	$17.85	$36.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.73 / $17.73 / $66.12	Professional	50	$17.73	$17.73	$66.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.53 / $17.91 / $19.29	Professional	52	$16.53	$17.91	$19.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.87 / $54.68 / $63.49	Professional	TC	$24.87	$54.68	$63.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.06 / $31.46 / $49.04	Facility		$9.06	$31.46	$49.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.82 / $39.34 / $72.93	Professional		$11.82	$39.34	$72.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $41.01 / $181.60	Facility		$41.01	$41.01	$181.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $31.68 / $31.68 / $31.68	Facility	TC	$31.68	$31.68	$31.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.10 / $45.50 / $169.95	Professional		$29.10	$45.50	$169.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $12.19 / $40.40	Professional	26	$6.91	$12.19	$40.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.68 / $35.14 / $130.96	Professional	TC	$20.68	$35.14	$130.96
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.90 / $281.76 / $450.69	Facility		$102.90	$281.76	$450.69
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $105.12 / $268.02 / $396.47	Facility	TC	$105.12	$268.02	$396.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.98 / $94.95 / $96.09	Professional		$59.98	$94.95	$96.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $17.80 / $22.06	Professional	26	$13.03	$17.80	$22.06
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.85 / $50.85 / $50.85	Professional	TC	$50.85	$50.85	$50.85
United Facility/Professional Professional Modifier Low / Median / High Price $25.16 / $40.97 / $71.48	Professional		$25.16	$40.97	$71.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.35 / $20.56	Professional	26	$6.61	$10.35	$20.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $29.55 / $48.95	Professional	TC	$18.35	$29.55	$48.95