Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.75 / $29.75 / $50.70	Facility	26	$29.75	$29.75	$50.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.43 / $70.69 / $101.61	Professional		$63.43	$70.69	$101.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.83 / $30.63 / $43.07	Professional	26	$27.83	$30.63	$43.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.54 / $40.92 / $64.04	Professional	TC	$36.54	$40.92	$64.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $97.81 / $155.50	Professional		$78.23	$97.81	$155.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $45.60 / $62.92	Professional	26	$36.09	$45.60	$62.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $117.37 / $146.71 / $233.25	Professional	50	$117.37	$146.71	$233.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.76 / $52.21 / $83.53	Professional	TC	$41.76	$52.21	$83.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.88 / $45.00 / $88.06	Professional		$31.88	$45.00	$88.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.24 / $36.24 / $36.24	Facility	26	$36.24	$36.24	$36.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.17 / $119.53 / $192.91	Professional		$75.17	$119.53	$192.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.02 / $43.23 / $73.23	Professional	26	$32.02	$43.23	$73.23
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.81 / $126.81 / $145.44	Professional	50	$126.81	$126.81	$145.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.64 / $71.59 / $132.49	Professional	TC	$43.64	$71.59	$132.49
United Facility/Professional Professional Modifier Low / Median / High Price $77.38 / $98.78 / $162.26	Professional		$77.38	$98.78	$162.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.57 / $37.07 / $60.50	Professional	26	$30.57	$37.07	$60.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.22 / $61.54 / $98.51	Professional	TC	$45.22	$61.54	$98.51