Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.61 / $149.33 / $639.00	Professional		$112.61	$149.33	$639.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $61.77 / $213.00	Professional	26	$42.60	$61.77	$213.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.95 / $98.44 / $414.00	Professional	TC	$74.95	$98.44	$414.00
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $286.48 / $286.48 / $286.48	Facility	26	$286.48	$286.48	$286.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.03 / $209.87 / $579.65	Professional		$178.03	$209.87	$579.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.79 / $76.37 / $199.34	Professional	26	$64.79	$76.37	$199.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $116.36 / $137.16 / $137.16	Professional	TC	$116.36	$137.16	$137.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.82 / $199.64 / $579.65	Professional		$182.82	$199.64	$579.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.04 / $68.81 / $199.34	Professional	26	$58.04	$68.81	$199.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.90 / $129.04 / $274.42	Professional	TC	$119.90	$129.04	$274.42
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $197.01 / $579.65	Professional		$164.59	$197.01	$579.65
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $56.42 / $68.81 / $199.34	Professional	26	$56.42	$68.81	$199.34
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $98.24 / $127.46 / $205.62	Professional	TC	$98.24	$127.46	$205.62
United Facility/Professional Professional Modifier Low / Median / High Price $142.55 / $183.26 / $316.57	Professional		$142.55	$183.26	$316.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.44 / $64.65 / $108.87	Professional	26	$49.44	$64.65	$108.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.25 / $117.98 / $207.70	Professional	TC	$92.25	$117.98	$207.70