Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $89.13 / $89.13	Facility	26	$81.28	$89.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $426.58 / $831.76	Professional		$316.23	$426.58	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $194.98	Professional	26	$81.28	$109.65	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $323.59 / $562.34	Professional	TC	$234.42	$323.59	$562.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $426.58 / $812.83	Professional		$416.87	$426.58	$812.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $100.00 / $165.96	Professional	26	$95.50	$100.00	$165.96
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $630.96 / $645.65 / $1,202.26	Professional	50	$630.96	$645.65	$1,202.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $331.13 / $660.69	Professional	TC	$309.03	$331.13	$660.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $125.89	Professional		$72.44	$104.71	$125.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $707.95 / $2,238.72	Professional		$389.05	$707.95	$2,238.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $154.88 / $426.58	Professional	26	$83.18	$154.88	$426.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $562.34 / $1,659.59	Professional	TC	$288.40	$562.34	$1,659.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $316.23	Professional		$32.36	$33.11	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $489.78 / $676.08	Professional		$338.84	$489.78	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $91.20 / $138.04	Professional	26	$79.43	$91.20	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $398.11 / $562.34	Professional	TC	$263.03	$398.11	$562.34