Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.25 / $334.80 / $957.60	Facility		$91.25	$334.80	$957.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.85 / $22.85 / $22.85	Facility	26	$22.85	$22.85	$22.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $68.39 / $159.30 / $867.60	Facility	TC	$68.39	$159.30	$867.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.96 / $100.34 / $130.00	Professional		$82.96	$100.34	$130.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $55.03 / $112.98	Professional	26	$23.28	$55.03	$112.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.18 / $81.27 / $257.02	Professional	TC	$62.18	$81.27	$257.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.43 / $86.69 / $129.96	Facility		$26.43	$86.69	$129.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.04 / $109.98 / $223.21	Professional		$36.04	$109.98	$223.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $180.72 / $180.72 / $180.72	Facility		$180.72	$180.72	$180.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.57 / $45.57 / $45.57	Facility	26	$45.57	$45.57	$45.57
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $135.15 / $135.15 / $135.15	Facility	TC	$135.15	$135.15	$135.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.14 / $53.99 / $141.80	Professional		$48.14	$53.99	$141.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $14.63 / $44.43	Professional	26	$11.68	$14.63	$44.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.19 / $41.28 / $104.44	Professional	TC	$34.19	$41.28	$104.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.21 / $129.21 / $129.21	Professional		$129.21	$129.21	$129.21
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.03 / $32.35 / $48.81	Professional	26	$28.03	$32.35	$48.81
United Facility/Professional Professional Modifier Low / Median / High Price $52.21 / $69.31 / $154.03	Professional		$52.21	$69.31	$154.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.71 / $21.46 / $47.64	Professional	26	$14.71	$21.46	$47.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.77 / $52.14 / $115.58	Professional	TC	$35.77	$52.14	$115.58