Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.19 / $26.87 / $34.04	Facility	26	$24.19	$26.87	$34.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $118.58 / $147.88	Professional		$90.73	$118.58	$147.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.26 / $26.99 / $42.69	Professional	26	$24.26	$26.99	$42.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $91.71 / $114.91	Professional	TC	$66.45	$91.71	$114.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.87 / $97.00 / $166.96	Professional		$83.87	$97.00	$166.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $30.92 / $44.69	Professional	26	$26.28	$30.92	$44.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.16 / $66.06 / $119.14	Professional	TC	$56.16	$66.06	$119.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $41.18 / $165.12	Professional		$28.00	$41.18	$165.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Facility	26	$32.15	$32.15	$32.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.26 / $146.40 / $230.76	Professional		$97.26	$146.40	$230.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.79 / $39.94 / $60.29	Professional	26	$26.79	$39.94	$60.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.23 / $110.05 / $177.60	Professional	TC	$69.23	$110.05	$177.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $83.54	Professional		$32.34	$32.34	$83.54
United Facility/Professional Professional Modifier Low / Median / High Price $91.24 / $122.42 / $175.27	Professional		$91.24	$122.42	$175.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $30.32 / $56.40	Professional	26	$24.51	$30.32	$56.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.23 / $90.51 / $127.73	Professional	TC	$63.23	$90.51	$127.73