Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.19 / $656.12 / $839.42	Facility		$98.19	$656.12	$839.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.75 / $30.52 / $46.60	Facility	26	$27.75	$30.52	$46.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $104.98 / $531.10 / $839.42	Facility	TC	$104.98	$531.10	$839.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $170.42 / $223.71	Professional		$80.23	$170.42	$223.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $58.06 / $61.57	Professional	26	$25.26	$58.06	$61.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.49 / $71.45 / $115.92	Professional	TC	$52.49	$71.45	$115.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $28.85 / $61.88 / $113.61	Facility		$28.85	$61.88	$113.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.48 / $75.73 / $175.60	Professional		$31.48	$75.73	$175.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.31 / $132.36 / $223.40	Facility		$97.31	$132.36	$223.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.67 / $31.67 / $31.67	Facility	26	$31.67	$31.67	$31.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.73 / $66.73 / $66.73	Facility	TC	$66.73	$66.73	$66.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.38 / $113.61 / $244.91	Professional		$70.38	$113.61	$244.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.72 / $38.79 / $86.59	Professional	26	$22.72	$38.79	$86.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.98 / $74.26 / $165.06	Professional	TC	$47.98	$74.26	$165.06
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.24 / $541.49 / $709.33	Facility		$120.24	$541.49	$709.33
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $374.98 / $725.87 / $733.58	Facility	26	$374.98	$725.87	$733.58
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $314.86 / $446.98 / $645.96	Facility	TC	$314.86	$446.98	$645.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.51 / $144.29 / $234.07	Professional		$139.51	$144.29	$234.07
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.36 / $48.05 / $74.31	Professional	26	$43.36	$48.05	$74.31
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.08 / $104.57 / $109.80	Professional	TC	$97.08	$104.57	$109.80
United Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $95.66 / $169.76	Professional		$58.36	$95.66	$169.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.84 / $30.56 / $78.54	Professional	26	$19.84	$30.56	$78.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.04 / $66.92 / $123.48	Professional	TC	$42.04	$66.92	$123.48