Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.01 / $595.72 / $889.98	Facility		$102.01	$595.72	$889.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.60 / $138.86 / $622.51	Professional		$89.60	$138.86	$622.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $39.67 / $163.11	Professional	26	$31.67	$39.67	$163.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.94 / $67.20 / $328.05	Professional	52	$35.94	$67.20	$328.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.45 / $99.56 / $201.04	Professional	TC	$62.45	$99.56	$201.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $559.57 / $636.37 / $1,205.89	Facility		$559.57	$636.37	$1,205.89
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $215.36 / $215.36 / $215.36	Facility	26	$215.36	$215.36	$215.36
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $517.95 / $964.83 / $1,006.12	Facility	TC	$517.95	$964.83	$1,006.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.12 / $168.70 / $464.41	Professional		$143.12	$168.70	$464.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.40 / $55.88 / $146.37	Professional	26	$47.40	$55.88	$146.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $99.87 / $99.87 / $117.73	Professional	TC	$99.87	$99.87	$117.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $268.14 / $268.14 / $867.35	Facility		$268.14	$268.14	$867.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.47 / $178.79 / $464.41	Professional		$155.47	$178.79	$464.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.97 / $50.93 / $146.37	Professional	26	$42.97	$50.93	$146.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.70 / $115.90 / $227.23	Professional	TC	$102.70	$115.90	$227.23
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $268.14 / $268.14 / $867.35	Facility		$268.14	$268.14	$867.35
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $131.38 / $157.16 / $464.41	Professional		$131.38	$157.16	$464.41
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $41.72 / $50.93 / $146.37	Professional	26	$41.72	$50.93	$146.37
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $89.65 / $106.87 / $173.99	Professional	TC	$89.65	$106.87	$173.99
United Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $160.76 / $253.64	Professional		$115.13	$160.76	$253.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.53 / $48.71 / $79.94	Professional	26	$37.53	$48.71	$79.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.75 / $109.28 / $188.74	Professional	TC	$77.75	$109.28	$188.74