Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.79 / $28.65 / $35.65	Facility	26	$25.79	$28.65	$35.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.13 / $77.64 / $131.66	Professional		$56.13	$77.64	$131.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.79 / $28.65 / $48.36	Professional	26	$25.79	$28.65	$48.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.81 / $30.89 / $51.98	Professional	52	$27.81	$30.89	$51.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.82 / $43.74 / $71.43	Professional	TC	$29.82	$43.74	$71.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.71 / $71.63 / $121.65	Professional		$62.71	$71.63	$121.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.75 / $29.74 / $47.66	Professional	26	$26.75	$29.74	$47.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $94.06 / $107.44 / $182.48	Professional	50	$94.06	$107.44	$182.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.79 / $41.22 / $73.98	Professional	TC	$36.79	$41.22	$73.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $40.15 / $84.06	Professional		$31.84	$40.15	$84.06
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 $61.79 / $97.24 / $158.94	Professional		$61.79	$97.24	$158.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.35 / $40.47 / $62.27	Professional	26	$26.35	$40.47	$62.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $58.82 / $92.71	Professional	TC	$33.88	$58.82	$92.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.05 / $32.34 / $54.43	Professional		$30.05	$32.34	$54.43
United Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $74.06 / $104.18	Professional		$55.55	$74.06	$104.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $31.62 / $45.29	Professional	26	$25.75	$31.62	$45.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.38 / $40.52 / $58.80	Professional	TC	$28.38	$40.52	$58.80