Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.62 / $30.69 / $43.58	Facility	26	$27.62	$30.69	$43.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $79.11 / $130.90	Professional		$61.96	$79.11	$130.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.62 / $30.69 / $51.26	Professional	26	$27.62	$30.69	$51.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.35 / $47.63 / $80.95	Professional	TC	$34.35	$47.63	$80.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $86.71 / $155.50	Professional		$73.70	$86.71	$155.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.60 / $37.17 / $56.98	Professional	26	$31.60	$37.17	$56.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $110.55 / $130.06 / $233.25	Professional	50	$110.55	$130.06	$233.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.10 / $49.53 / $102.60	Professional	TC	$42.10	$49.53	$102.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.07 / $42.10 / $91.94	Professional		$34.07	$42.10	$91.94
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 $71.41 / $114.50 / $190.29	Professional		$71.41	$114.50	$190.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $45.67 / $71.27	Professional	26	$30.20	$45.67	$71.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.24 / $70.22 / $124.33	Professional	TC	$42.24	$70.22	$124.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $72.74	Professional		$32.34	$32.34	$72.74
United Facility/Professional Professional Modifier Low / Median / High Price $78.11 / $96.18 / $152.12	Professional		$78.11	$96.18	$152.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.16 / $37.15 / $52.74	Professional	26	$31.16	$37.15	$52.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.76 / $56.53 / $90.44	Professional	TC	$47.76	$56.53	$90.44