Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.53 / $121.58 / $121.58	Facility	26	$110.53	$121.58	$121.58
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $140.90 / $140.90 / $140.90	Facility	53	$140.90	$140.90	$140.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $704.49 / $785.61 / $1,050.06	Professional		$704.49	$785.61	$1,050.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.65 / $187.33 / $234.44	Professional	26	$103.65	$187.33	$234.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $352.25 / $380.81 / $392.81	Professional	52	$352.25	$380.81	$392.81
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $140.90 / $152.32 / $157.12	Professional	53	$140.90	$152.32	$157.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $593.96 / $664.95 / $843.98	Professional	TC	$593.96	$664.95	$843.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.52 / $123.52 / $123.52	Professional		$123.52	$123.52	$123.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.71 / $126.71 / $126.71	Facility	26	$126.71	$126.71	$126.71
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $163.30 / $163.30 / $163.30	Facility	53	$163.30	$163.30	$163.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $659.14 / $962.02 / $3,942.38	Professional		$659.14	$962.02	$3,942.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.05 / $183.37 / $798.75	Professional	26	$104.05	$183.37	$798.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $549.88 / $807.66 / $2,742.44	Professional	TC	$549.88	$807.66	$2,742.44
United Facility/Professional Professional Modifier Low / Median / High Price $678.57 / $949.65 / $1,793.59	Professional		$678.57	$949.65	$1,793.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.59 / $205.00 / $320.77	Professional	26	$114.59	$205.00	$320.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $540.50 / $896.94 / $1,353.17	Professional	TC	$540.50	$896.94	$1,353.17