Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.66 / $549.00 / $823.50	Facility		$85.66	$549.00	$823.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.42 / $53.42 / $53.42	Facility	26	$53.42	$53.42	$53.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.53 / $58.62 / $371.99	Facility	TC	$22.53	$58.62	$371.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.87 / $85.66 / $93.22	Professional		$77.87	$85.66	$93.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.96 / $131.21 / $387.06	Professional	26	$54.96	$131.21	$387.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.31 / $35.97 / $38.26	Professional	TC	$29.31	$35.97	$38.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.59 / $66.97 / $121.46	Facility		$37.59	$66.97	$121.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.26 / $92.09 / $208.61	Professional		$51.26	$92.09	$208.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.63 / $139.63 / $139.63	Facility		$139.63	$139.63	$139.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.98 / $91.98 / $91.98	Facility	26	$91.98	$91.98	$91.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $47.65 / $47.65 / $47.65	Facility	TC	$47.65	$47.65	$47.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.57 / $49.29 / $146.13	Professional		$44.57	$49.29	$146.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.16 / $32.35 / $102.50	Professional	26	$27.16	$32.35	$102.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $19.42 / $49.38	Professional	TC	$15.19	$19.42	$49.38
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.86 / $80.13 / $113.83	Professional	26	$71.86	$80.13	$113.83
United Facility/Professional Professional Modifier Low / Median / High Price $50.90 / $75.14 / $143.96	Professional		$50.90	$75.14	$143.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.32 / $43.70 / $92.19	Professional	26	$34.32	$43.70	$92.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.57 / $21.18 / $54.66	Professional	TC	$16.57	$21.18	$54.66