Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.99 / $100.89 / $113.57	Facility		$89.99	$100.89	$113.57
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.09 / $37.75 / $48.52	Facility	26	$37.09	$37.75	$48.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.36 / $86.65 / $106.64	Professional		$36.36	$86.65	$106.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.71 / $31.63 / $56.58	Professional	26	$21.71	$31.63	$56.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.19 / $43.09 / $51.81	Professional	52	$18.19	$43.09	$51.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.83 / $52.24 / $66.51	Professional	TC	$13.83	$52.24	$66.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.22 / $110.22 / $110.22	Facility		$110.22	$110.22	$110.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.98 / $89.98 / $89.98	Professional		$67.98	$89.98	$89.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.99 / $42.34 / $42.34	Professional	26	$31.99	$42.34	$42.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.00 / $47.65 / $47.65	Professional	TC	$36.00	$47.65	$47.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.91 / $33.31 / $56.93	Facility		$16.91	$33.31	$56.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.37 / $31.52 / $59.46	Professional		$15.37	$31.52	$59.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.39 / $96.39 / $96.39	Facility		$96.39	$96.39	$96.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.57 / $86.77 / $111.38	Professional		$45.57	$86.77	$111.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.73 / $36.79 / $49.17	Professional	26	$27.73	$36.79	$49.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $48.45 / $70.43	Professional	TC	$16.48	$48.45	$70.43
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $73.40 / $73.40 / $73.40	Professional		$73.40	$73.40	$73.40
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $47.98 / $47.98 / $47.98	Professional	26	$47.98	$47.98	$47.98
United Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $69.84 / $111.80	Professional		$55.06	$69.84	$111.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.42 / $34.40 / $54.58	Professional	26	$25.42	$34.40	$54.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.85 / $34.13 / $70.25	Professional	TC	$25.85	$34.13	$70.25