Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $264.14 / $640.29 / $1,205.17	Facility		$264.14	$640.29	$1,205.17
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.39 / $23.52 / $35.72	Facility	26	$21.39	$23.52	$35.72
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $264.14 / $510.42 / $1,127.06	Facility	TC	$264.14	$510.42	$1,127.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $120.46 / $238.07	Professional		$26.31	$120.46	$238.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $31.20 / $45.74	Professional	26	$19.75	$31.20	$45.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.12 / $102.26 / $182.88	Professional	TC	$88.12	$102.26	$182.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.73 / $101.48 / $152.22	Facility		$21.73	$101.48	$152.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.70 / $108.58 / $235.28	Professional		$23.70	$108.58	$235.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $132.36 / $133.10 / $296.58	Facility		$132.36	$133.10	$296.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.98 / $23.98 / $23.98	Facility	26	$23.98	$23.98	$23.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $109.98 / $109.98 / $109.98	Facility	TC	$109.98	$109.98	$109.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.91 / $152.21 / $306.23	Professional		$107.91	$152.21	$306.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.62 / $27.65 / $64.27	Professional	26	$19.62	$27.65	$64.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.51 / $122.58 / $241.47	Professional	TC	$87.51	$122.58	$241.47
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $302.80 / $485.81 / $742.49	Facility		$302.80	$485.81	$742.49
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $342.30 / $342.30 / $342.30	Facility	26	$342.30	$342.30	$342.30
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $309.22 / $480.15 / $899.12	Facility	TC	$309.22	$480.15	$899.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.90 / $194.35 / $208.56	Professional		$184.90	$194.35	$208.56
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.38 / $36.11 / $55.91	Professional	26	$32.38	$36.11	$55.91
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.68 / $178.04 / $180.96	Professional	TC	$157.68	$178.04	$180.96
United Facility/Professional Professional Modifier Low / Median / High Price $98.35 / $159.94 / $289.88	Professional		$98.35	$159.94	$289.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $28.63 / $46.46	Professional	26	$18.89	$28.63	$46.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.34 / $125.92 / $253.43	Professional	TC	$78.34	$125.92	$253.43