Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.00 / $22.22 / $30.12	Facility	26	$20.00	$22.22	$30.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.05 / $127.83 / $134.65	Professional		$115.05	$127.83	$134.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.28 / $105.61 / $113.03	Professional	TC	$94.28	$105.61	$113.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.51 / $99.43 / $177.95	Professional		$84.51	$99.43	$177.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.85 / $72.77 / $137.85	Professional	TC	$61.85	$72.77	$137.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.76 / $34.90 / $180.59	Professional		$24.76	$34.90	$180.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $156.00 / $250.50	Professional		$104.10	$156.00	$250.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.84 / $123.64 / $198.62	Professional	TC	$81.84	$123.64	$198.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $76.76	Professional		$32.34	$32.34	$76.76
United Facility/Professional Professional Modifier Low / Median / High Price $93.53 / $127.32 / $190.26	Professional		$93.53	$127.32	$190.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.15 / $96.36 / $147.66	Professional	TC	$72.15	$96.36	$147.66