Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.39 / $13.62 / $19.68	Facility	26	$12.39	$13.62	$19.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $115.56 / $165.40	Professional		$74.56	$115.56	$165.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.34 / $12.60 / $26.24	Professional	26	$11.34	$12.60	$26.24
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.28 / $40.14 / $46.26	Professional	52	$37.28	$40.14	$46.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.17 / $80.63 / $130.94	Professional	TC	$62.17	$80.63	$130.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.60 / $75.09 / $162.74	Professional		$13.60	$75.09	$162.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.52 / $105.29 / $224.17	Professional		$74.52	$105.29	$224.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $15.86 / $33.29	Professional	26	$11.06	$15.86	$33.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.98 / $88.29 / $188.78	Professional	TC	$62.98	$88.29	$188.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.01 / $91.38 / $95.91	Professional		$87.01	$91.38	$95.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $13.52 / $20.51	Professional	26	$12.37	$13.52	$20.51
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $86.02 / $86.02 / $86.02	Professional	TC	$86.02	$86.02	$86.02
United Facility/Professional Professional Modifier Low / Median / High Price $68.47 / $108.28 / $209.06	Professional		$68.47	$108.28	$209.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $14.78 / $21.91	Professional	26	$10.28	$14.78	$21.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.90 / $99.63 / $219.02	Professional	TC	$56.90	$99.63	$219.02