Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $905.79 / $927.51 / $993.69	Facility		$905.79	$927.51	$993.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $128.82 / $479.00	Professional		$107.34	$128.82	$479.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $35.72 / $148.00	Professional	26	$24.07	$35.72	$148.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.09 / $60.27 / $337.21	Professional	52	$37.09	$60.27	$337.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.28 / $95.63 / $501.61	Professional	TC	$83.28	$95.63	$501.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $515.71 / $683.88 / $1,084.64	Facility		$515.71	$683.88	$1,084.64
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $161.24 / $161.24 / $161.24	Facility	26	$161.24	$161.24	$161.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.78 / $158.87 / $475.79	Professional		$134.78	$158.87	$475.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $42.71 / $113.42	Professional	26	$36.22	$42.71	$113.42
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $103.46 / $121.95 / $121.95	Professional	TC	$103.46	$121.95	$121.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $268.14 / $268.14 / $763.31	Facility		$268.14	$268.14	$763.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.15 / $161.97 / $475.79	Professional		$140.15	$161.97	$475.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.34 / $38.72 / $113.42	Professional	26	$33.34	$38.72	$113.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.77 / $122.47 / $259.12	Professional	TC	$102.77	$122.47	$259.12
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $268.14 / $268.14 / $763.31	Facility		$268.14	$268.14	$763.31
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $123.65 / $161.28 / $475.79	Professional		$123.65	$161.28	$475.79
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $31.70 / $38.72 / $113.42	Professional	26	$31.70	$38.72	$113.42
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $89.00 / $121.09 / $199.94	Professional	TC	$89.00	$121.09	$199.94
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $135.91 / $259.85	Professional		$108.47	$135.91	$259.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.84 / $35.81 / $61.94	Professional	26	$27.84	$35.81	$61.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.63 / $107.64 / $197.91	Professional	TC	$80.63	$107.64	$197.91