Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.88 / $306.44 / $612.88	Facility		$85.88	$306.44	$612.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.29 / $8.01 / $12.32	Facility	26	$7.29	$8.01	$12.32
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $88.22 / $309.70 / $684.32	Facility	TC	$88.22	$309.70	$684.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.30 / $27.30 / $59.07	Professional		$15.30	$27.30	$59.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $15.68 / $31.72	Professional	26	$6.71	$15.68	$31.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.78 / $56.78 / $56.78	Professional	50	$56.78	$56.78	$56.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.72 / $13.65 / $16.20	Professional	52	$12.72	$13.65	$16.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $22.31 / $43.65	Professional	TC	$18.16	$22.31	$43.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.05 / $24.72 / $38.39	Facility		$8.05	$24.72	$38.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.50 / $29.50 / $57.31	Professional		$10.50	$29.50	$57.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.07 / $32.07 / $181.60	Facility		$32.07	$32.07	$181.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $8.51	Facility	26	$8.51	$8.51	$8.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $23.86	Facility	TC	$23.86	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.71 / $35.72 / $82.13	Professional		$22.71	$35.72	$82.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.10 / $10.96 / $38.57	Professional	26	$6.10	$10.96	$38.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.79 / $27.01 / $98.23	Professional	TC	$16.79	$27.01	$98.23
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.61 / $354.89 / $441.95	Facility		$101.61	$354.89	$441.95
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $117.44 / $268.50 / $388.00	Facility	TC	$117.44	$268.50	$388.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $76.09 / $76.09	Professional		$76.09	$76.09	$76.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $17.87 / $24.92	Professional	26	$11.21	$17.87	$24.92
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.43 / $57.43 / $57.43	Professional	TC	$57.43	$57.43	$57.43
United Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $33.78 / $59.29	Professional		$19.79	$33.78	$59.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.33 / $18.26	Professional	26	$6.03	$9.33	$18.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.34 / $21.79 / $40.15	Professional	TC	$14.34	$21.79	$40.15