Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $35.48 / $38.90	Facility	26	$34.67	$35.48	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $363.08	Professional		$107.15	$147.91	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $52.48 / $91.20	Professional	26	$32.36	$52.48	$91.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $20.42 / $60.26 / $204.17	Professional	52	$20.42	$60.26	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $100.00 / $190.55	Professional	TC	$79.43	$100.00	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $123.03 / $269.15	Professional		$47.86	$123.03	$269.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $41.69 / $58.88	Facility	26	$8.91	$41.69	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $173.78 / $602.56	Professional		$97.72	$173.78	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $51.29 / $169.82	Professional	26	$28.18	$51.29	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $128.82 / $436.52	Professional	TC	$70.79	$128.82	$436.52
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $208.93 / $338.84	Professional		$61.66	$208.93	$338.84
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $61.66 / $95.50	Professional	26	$54.95	$61.66	$95.50
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	52	$97.72	$97.72	$97.72
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $158.49 / $165.96	Professional	TC	$77.62	$158.49	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $269.15	Professional		$102.33	$154.88	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $43.65 / $79.43	Professional	26	$26.92	$43.65	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $112.20 / $199.53	Professional	TC	$74.13	$112.20	$199.53