Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,060.40 / $1,060.40 / $1,060.40	Facility		$1,060.40	$1,060.40	$1,060.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.20 / $187.84 / $681.00	Professional		$125.20	$187.84	$681.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.34 / $23.55 / $31.95	Professional	26	$19.34	$23.55	$31.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $71.86 / $89.59 / $357.34	Professional	52	$71.86	$89.59	$357.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.24 / $164.30 / $188.12	Professional	TC	$125.24	$164.30	$188.12
BCBS Facility/Professional Facility Modifier Low / Median / High Price $156.11 / $156.11 / $162.93	Facility		$156.11	$156.11	$162.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.50 / $216.30 / $471.31	Professional		$183.50	$216.30	$471.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.81 / $38.67 / $76.08	Professional	26	$32.81	$38.67	$76.08
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.25 / $169.25 / $199.51	Professional	TC	$169.25	$169.25	$199.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $364.87 / $364.87 / $364.87	Facility		$364.87	$364.87	$364.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $256.35 / $471.31	Professional		$145.49	$256.35	$471.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.89 / $30.64 / $76.08	Professional	26	$22.89	$30.64	$76.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.49 / $204.86 / $303.75	Professional	TC	$122.49	$204.86	$303.75
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $364.87 / $364.87 / $364.87	Facility		$364.87	$364.87	$364.87
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $232.99 / $471.31	Professional		$145.49	$232.99	$471.31
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $22.99 / $31.05 / $76.08	Professional	26	$22.99	$31.05	$76.08
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $122.49 / $184.01 / $251.50	Professional	TC	$122.49	$184.01	$251.50
United Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $239.86 / $548.83	Professional		$134.97	$239.86	$548.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.31 / $31.15 / $89.62	Professional	26	$22.31	$31.15	$89.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.98 / $213.29 / $459.21	Professional	TC	$111.98	$213.29	$459.21