Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $295.12 / $660.69	Facility		$61.66	$295.12	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $8.13 / $13.49	Facility	26	$8.13	$8.13	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $57.54 / $331.13 / $691.83	Facility	TC	$57.54	$331.13	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $35.48 / $81.28	Professional		$9.77	$35.48	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $17.38 / $36.31	Professional	26	$7.24	$17.38	$36.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $69.18 / $213.80	Professional	50	$17.78	$69.18	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $52.48 / $79.43	Professional	TC	$22.91	$52.48	$79.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.23 / $33.88 / $53.70	Facility		$10.23	$33.88	$53.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $35.48 / $75.86	Professional		$10.96	$35.48	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $181.97	Facility		$56.23	$56.23	$181.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.46 / $30.20 / $43.65	Facility	TC	$6.46	$30.20	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $46.77 / $169.82	Professional		$26.92	$46.77	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $12.02 / $41.69	Professional	26	$6.46	$12.02	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.90 / $131.83	Professional	TC	$20.89	$38.90	$131.83
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $269.15 / $501.19	Facility		$104.71	$269.15	$501.19
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $91.20 / $269.15 / $398.11	Facility	TC	$91.20	$269.15	$398.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $95.50 / $97.72	Professional		$58.88	$95.50	$97.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.78 / $21.88	Professional	26	$12.88	$17.78	$21.88
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $50.12 / $51.29	Professional	TC	$50.12	$50.12	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $245.47	Facility		$245.47	$245.47	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $67.61	Professional		$22.91	$34.67	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $10.00 / $18.20	Professional	26	$6.17	$10.00	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $48.98	Professional	TC	$16.98	$25.12	$48.98