Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.69 / $138.69 / $138.69	Facility	26	$138.69	$138.69	$138.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $638.29 / $761.38 / $929.72	Professional		$638.29	$761.38	$929.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.17 / $131.91 / $168.36	Professional	26	$127.17	$131.91	$168.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $286.45 / $387.49 / $387.49	Professional	52	$286.45	$387.49	$387.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $511.12 / $629.47 / $761.36	Professional	TC	$511.12	$629.47	$761.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,059.71 / $1,249.16 / $2,235.61	Professional		$1,059.71	$1,249.16	$2,235.61
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $241.19 / $284.31 / $425.11	Professional	26	$241.19	$284.31	$425.11
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $818.47 / $964.79 / $964.79	Professional	TC	$818.47	$964.79	$964.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.14 / $908.80 / $2,235.61	Professional		$489.14	$908.80	$2,235.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.93 / $178.23 / $425.11	Professional	26	$88.93	$178.23	$425.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $400.22 / $722.94 / $1,111.99	Professional	TC	$400.22	$722.94	$1,111.99
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $806.76 / $870.02 / $1,387.05	Professional		$806.76	$870.02	$1,387.05
MVP Health Care Facility/Professional Professional Modifier 26 Low / Median / High Price $155.55 / $171.86 / $275.06	Professional	26	$155.55	$171.86	$275.06
MVP Health Care Facility/Professional Professional Modifier TC Low / Median / High Price $649.08 / $698.14 / $991.47	Professional	TC	$649.08	$698.14	$991.47
United Facility/Professional Professional Modifier Low / Median / High Price $871.18 / $1,103.68 / $2,532.58	Professional		$871.18	$1,103.68	$2,532.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $172.76 / $239.85 / $502.23	Professional	26	$172.76	$239.85	$502.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $641.82 / $856.31 / $2,030.35	Professional	TC	$641.82	$856.31	$2,030.35