Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.80 / $27.80 / $47.42	Facility	26	$27.80	$27.80	$47.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $69.30 / $105.38	Professional		$59.33	$69.30	$105.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.79 / $28.10 / $38.11	Professional	26	$25.79	$28.10	$38.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.47 / $31.75 / $38.28	Professional	52	$28.47	$31.75	$38.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.92 / $35.56 / $54.49	Professional	TC	$30.92	$35.56	$54.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $82.30 / $127.56	Professional		$65.84	$82.30	$127.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.74 / $37.79 / $53.67	Professional	26	$29.74	$37.79	$53.67
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $98.76 / $123.45 / $191.34	Professional	50	$98.76	$123.45	$191.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.72 / $44.50 / $68.97	Professional	TC	$35.72	$44.50	$68.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.81 / $42.09 / $80.50	Professional		$29.81	$42.09	$80.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.92 / $99.15 / $169.13	Professional		$65.92	$99.15	$169.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.20 / $38.49 / $63.28	Professional	26	$28.20	$38.49	$63.28
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.56 / $85.56 / $97.82	Professional	50	$85.56	$85.56	$97.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.14 / $58.71 / $104.61	Professional	TC	$37.14	$58.71	$104.61
United Facility/Professional Professional Modifier Low / Median / High Price $59.03 / $74.64 / $122.13	Professional		$59.03	$74.64	$122.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $31.58 / $56.06	Professional	26	$26.98	$31.58	$56.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.40 / $44.94 / $72.14	Professional	TC	$31.40	$44.94	$72.14