Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.70 / $626.40 / $1,377.00	Facility		$74.70	$626.40	$1,377.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.76 / $29.76 / $71.40	Facility	26	$29.76	$29.76	$71.40
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $93.63 / $403.20 / $964.80	Facility	TC	$93.63	$403.20	$964.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.82 / $64.98 / $147.26	Professional		$50.82	$64.98	$147.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $152.88 / $854.50	Professional	26	$33.61	$152.88	$854.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.93 / $32.49 / $32.49	Professional	52	$26.93	$32.49	$32.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $31.89 / $845.90	Professional	TC	$24.44	$31.89	$845.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.99 / $44.99 / $85.86	Facility		$32.99	$44.99	$85.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.99 / $73.19 / $147.47	Professional		$35.99	$73.19	$147.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.00 / $146.00 / $146.00	Facility		$146.00	$146.00	$146.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.29 / $78.29 / $78.29	Facility	26	$78.29	$78.29	$78.29
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $67.70 / $67.70 / $67.70	Facility	TC	$67.70	$67.70	$67.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.80 / $47.39 / $135.97	Professional		$31.80	$47.39	$135.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $20.32 / $62.49	Professional	26	$16.39	$20.32	$62.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.99 / $29.59 / $81.31	Professional	TC	$14.99	$29.59	$81.31
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.45 / $68.45 / $82.19	Professional		$68.45	$68.45	$82.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.06 / $45.41 / $69.06	Professional	26	$34.06	$45.41	$69.06
United Facility/Professional Professional Modifier Low / Median / High Price $35.96 / $73.63 / $151.78	Professional		$35.96	$73.63	$151.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.75 / $27.88 / $58.92	Professional	26	$20.75	$27.88	$58.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.21 / $46.61 / $101.25	Professional	TC	$15.21	$46.61	$101.25