Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,007.26 / $1,007.26 / $1,007.26	Professional		$1,007.26	$1,007.26	$1,007.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.97 / $107.97 / $107.97	Professional	26	$107.97	$107.97	$107.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $899.28 / $899.28 / $899.28	Professional	TC	$899.28	$899.28	$899.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,151.08 / $1,151.08 / $3,609.61	Professional		$1,151.08	$1,151.08	$3,609.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,206.96 / $1,302.43 / $3,609.61	Professional		$1,206.96	$1,302.43	$3,609.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $132.41 / $142.96 / $406.03	Professional	26	$132.41	$142.96	$406.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,064.00 / $1,118.32 / $2,531.66	Professional	TC	$1,064.00	$1,118.32	$2,531.66
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,206.96 / $1,302.43 / $3,609.61	Professional		$1,206.96	$1,302.43	$3,609.61
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $132.41 / $142.28 / $406.03	Professional	26	$132.41	$142.28	$406.03
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $1,064.00 / $1,162.59 / $2,531.66	Professional	TC	$1,064.00	$1,162.59	$2,531.66
United Facility/Professional Professional Modifier Low / Median / High Price $908.79 / $1,361.72 / $1,971.37	Professional		$908.79	$1,361.72	$1,971.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.43 / $150.40 / $221.75	Professional	26	$99.43	$150.40	$221.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $809.36 / $1,251.15 / $3,407.76	Professional	TC	$809.36	$1,251.15	$3,407.76