Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.29 / $721.92 / $973.84	Facility		$99.29	$721.92	$973.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.28 / $37.71 / $57.57	Facility	26	$34.28	$37.71	$57.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $162.50 / $730.42 / $1,131.76	Facility	TC	$162.50	$730.42	$1,131.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.29 / $212.13 / $229.68	Professional		$99.29	$212.13	$229.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $72.00 / $75.95	Professional	26	$31.67	$72.00	$75.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.10 / $49.65 / $68.84	Professional	52	$44.10	$49.65	$68.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.00 / $87.95 / $138.08	Professional	TC	$65.00	$87.95	$138.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.20 / $76.70 / $141.41	Facility		$36.20	$76.70	$141.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.49 / $94.28 / $218.60	Professional		$39.49	$94.28	$218.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.16 / $132.36 / $224.28	Facility		$121.16	$132.36	$224.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.13 / $40.13 / $40.13	Facility	26	$40.13	$40.13	$40.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $82.40 / $82.40 / $82.40	Facility	TC	$82.40	$82.40	$82.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.43 / $141.41 / $307.36	Professional		$87.43	$141.41	$307.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $47.93 / $108.40	Professional	26	$28.80	$47.93	$108.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.35 / $92.05 / $206.82	Professional	TC	$59.35	$92.05	$206.82
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $370.03 / $541.49 / $801.74	Facility		$370.03	$541.49	$801.74
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $321.79 / $453.27 / $866.67	Facility	TC	$321.79	$453.27	$866.67
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.71 / $189.87 / $288.04	Professional		$168.71	$189.87	$288.04
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.77 / $60.39 / $93.28	Professional	26	$56.77	$60.39	$93.28
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.13 / $124.04 / $129.11	Professional	TC	$118.13	$124.04	$129.11
United Facility/Professional Professional Modifier Low / Median / High Price $86.74 / $120.93 / $218.75	Professional		$86.74	$120.93	$218.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.09 / $36.40 / $66.06	Professional	26	$25.09	$36.40	$66.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.17 / $83.62 / $157.02	Professional	TC	$58.17	$83.62	$157.02