Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $891.25 / $912.01	Facility		$338.84	$891.25	$912.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $676.08 / $676.08 / $707.95	Facility	TC	$676.08	$676.08	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $169.82 / $416.87	Professional		$72.44	$169.82	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $57.54 / $100.00	Professional	26	$25.12	$57.54	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $87.10 / $309.03	Professional	TC	$50.12	$87.10	$309.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $588.84 / $831.76	Facility		$407.38	$588.84	$831.76
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	26	$173.78	$173.78	$173.78
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $416.87 / $416.87 / $812.83	Facility	TC	$416.87	$416.87	$812.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $131.83	Professional		$112.20	$131.83	$131.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $41.69 / $41.69	Professional	26	$35.48	$41.69	$41.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $91.20 / $91.20	Professional	TC	$77.62	$91.20	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $691.83 / $691.83	Facility		$269.15	$691.83	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $371.54	Professional		$117.49	$158.49	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $40.74 / $117.49	Professional	26	$20.42	$40.74	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $93.33 / $257.04	Professional	TC	$81.28	$93.33	$257.04
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $371.54	Professional		$89.13	$93.33	$371.54
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $30.90 / $117.49	Professional	26	$28.18	$30.90	$117.49
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $63.10 / $81.28	Professional	TC	$61.66	$63.10	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $112.20 / $239.88	Professional		$93.33	$112.20	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $33.88 / $72.44	Professional	26	$28.18	$33.88	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $72.44 / $154.88	Professional	TC	$60.26	$72.44	$154.88