Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $446.68 / $660.69	Facility		$112.20	$446.68	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $31.62 / $34.67	Facility	26	$30.90	$31.62	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $87.10 / $204.17	Professional		$66.07	$87.10	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $66.07 / $100.00	Professional	26	$28.18	$66.07	$100.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $104.71 / $295.12	Professional	50	$48.98	$104.71	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $53.70 / $102.33	Professional	TC	$43.65	$53.70	$102.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $56.23 / $114.82	Facility		$34.67	$56.23	$114.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $74.13 / $123.03	Professional		$33.11	$74.13	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $131.83 / $181.97	Facility		$109.65	$131.83	$181.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $398.11	Professional		$67.61	$114.82	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $46.77 / $151.36	Professional	26	$26.30	$46.77	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $67.61 / $245.47	Professional	TC	$41.69	$67.61	$245.47
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $380.19 / $537.03	Facility		$162.18	$380.19	$537.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $134.90 / $147.91	Professional		$77.62	$134.90	$147.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $87.10 / $107.15	Professional	26	$56.23	$87.10	$107.15
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	50	$208.93	$208.93	$208.93
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $95.50 / $97.72	Professional	TC	$89.13	$95.50	$97.72
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 $67.61 / $89.13 / $169.82	Professional		$67.61	$89.13	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $66.07	Professional	26	$24.55	$33.88	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $54.95 / $104.71	Professional	TC	$40.74	$54.95	$104.71