Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.96 / $82.96 / $112.46	Facility	26	$82.96	$82.96	$112.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.14 / $416.43 / $613.42	Professional		$318.14	$416.43	$613.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.96 / $88.79 / $140.00	Professional	26	$82.96	$88.79	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $235.18 / $279.52 / $453.84	Professional	TC	$235.18	$279.52	$453.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $351.87 / $429.47 / $656.94	Professional		$351.87	$429.47	$656.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $100.01 / $147.16	Professional	26	$85.00	$100.01	$147.16
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $527.79 / $644.20 / $985.42	Professional	50	$527.79	$644.20	$985.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.00 / $329.47 / $496.95	Professional	TC	$260.00	$329.47	$496.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.41 / $127.06 / $441.59	Professional		$79.41	$127.06	$441.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.37 / $97.37 / $97.37	Facility	26	$97.37	$97.37	$97.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $400.81 / $626.58 / $1,050.47	Professional		$400.81	$626.58	$1,050.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.75 / $133.68 / $205.74	Professional	26	$79.75	$133.68	$205.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $300.05 / $497.48 / $872.19	Professional	TC	$300.05	$497.48	$872.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $387.62	Professional		$32.34	$32.34	$387.62
United Facility/Professional Professional Modifier Low / Median / High Price $350.30 / $478.75 / $694.05	Professional		$350.30	$478.75	$694.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.31 / $92.16 / $132.81	Professional	26	$79.31	$92.16	$132.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $261.54 / $368.84 / $564.90	Professional	TC	$261.54	$368.84	$564.90