Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $48.98 / $48.98	Facility	26	$43.65	$48.98	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $112.20 / $389.05	Professional		$79.43	$112.20	$389.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $72.44 / $190.55	Professional	26	$41.69	$72.44	$190.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $186.21 / $436.52	Professional	50	$173.78	$186.21	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $52.48 / $79.43	Professional	TC	$39.81	$52.48	$79.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $85.11 / $194.98	Professional		$41.69	$85.11	$194.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $50.12 / $72.44	Facility	26	$10.72	$50.12	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $436.52	Professional		$87.10	$131.83	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $70.79 / $208.93	Professional	26	$42.66	$70.79	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $61.66 / $229.09	Professional	TC	$41.69	$61.66	$229.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $194.98	Professional		$89.13	$120.23	$194.98
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $89.13 / $93.33	Professional	26	$61.66	$89.13	$93.33
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $257.04 / $257.04 / $389.05	Professional	50	$257.04	$257.04	$389.05
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $70.79 / $70.79	Professional	TC	$70.79	$70.79	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $151.36	Professional		$74.13	$107.15	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $53.70 / $77.62	Professional	26	$38.02	$53.70	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $50.12 / $75.86	Professional	TC	$35.48	$50.12	$75.86