Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.57 / $383.12 / $1,138.96	Facility		$112.57	$383.12	$1,138.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.90 / $21.67 / $55.69	Facility	26	$20.90	$21.67	$55.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $97.41 / $266.20 / $1,196.00	Facility	TC	$97.41	$266.20	$1,196.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.98 / $130.50 / $414.00	Professional		$113.98	$130.50	$414.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $23.55 / $58.85	Professional	26	$21.17	$23.55	$58.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.41 / $106.95 / $131.44	Professional	TC	$97.41	$106.95	$131.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $193.48 / $193.48 / $193.48	Facility		$193.48	$193.48	$193.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.21 / $165.60 / $219.11	Professional		$104.21	$165.60	$219.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $25.16 / $38.29	Professional	26	$17.80	$25.16	$38.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.22 / $137.80 / $183.09	Professional	TC	$93.22	$137.80	$183.09
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $293.24 / $525.70 / $1,277.84	Facility		$293.24	$525.70	$1,277.84
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $543.04 / $547.64 / $932.50	Facility	TC	$543.04	$547.64	$932.50
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.39 / $20.93 / $20.93	Professional	26	$20.39	$20.93	$20.93
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.03 / $97.03 / $97.03	Professional	TC	$97.03	$97.03	$97.03
United Facility/Professional Professional Modifier Low / Median / High Price $119.46 / $189.77 / $303.61	Professional		$119.46	$189.77	$303.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.38 / $26.13 / $55.91	Professional	26	$18.38	$26.13	$55.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.90 / $155.31 / $252.02	Professional	TC	$87.90	$155.31	$252.02