Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $131.83 / $398.11	Facility		$40.74	$131.83	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $8.51 / $9.33	Facility	26	$7.94	$8.51	$9.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $89.13 / $302.00 / $407.38	Facility	TC	$89.13	$302.00	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $44.67 / $75.86	Professional		$23.99	$44.67	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.23 / $29.51	Professional	26	$7.08	$10.23	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.92 / $44.67	Professional	TC	$16.98	$26.92	$44.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.47 / $26.30 / $44.67	Facility		$10.47	$26.30	$44.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $28.84 / $63.10	Professional		$11.48	$28.84	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $181.97	Facility		$46.77	$46.77	$181.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.11	Facility	TC	$5.01	$23.44	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $38.90 / $141.25	Professional		$22.39	$38.90	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $12.59 / $40.74	Professional	26	$6.76	$12.59	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.70 / $100.00	Professional	TC	$15.85	$25.70	$100.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $316.23 / $467.74	Facility		$107.15	$316.23	$467.74
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $91.20 / $251.19 / $389.05	Facility	TC	$91.20	$251.19	$389.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $48.98 / $81.28	Professional		$28.84	$48.98	$81.28
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $14.79 / $22.91	Professional	26	$13.18	$14.79	$22.91
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $35.48	Professional	TC	$35.48	$35.48	$35.48
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 $21.38 / $30.90 / $56.23	Professional		$21.38	$30.90	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.47 / $18.62	Professional	26	$6.61	$10.47	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $20.42 / $38.02	Professional	TC	$14.45	$20.42	$38.02