Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $146.19 / $146.19 / $187.39	Facility	26	$146.19	$146.19	$187.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $415.68 / $473.49	Professional		$317.47	$415.68	$473.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $146.19 / $182.28	Professional	26	$131.81	$146.19	$182.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.65 / $269.50 / $310.86	Professional	TC	$185.65	$269.50	$310.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.52 / $284.82 / $505.27	Professional		$276.52	$284.82	$505.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.69 / $117.10 / $196.33	Professional	26	$113.69	$117.10	$196.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.83 / $167.71 / $322.64	Professional	TC	$162.83	$167.71	$322.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $163.84 / $235.08 / $588.59	Professional		$163.84	$235.08	$588.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.76 / $172.76 / $172.76	Facility	26	$172.76	$172.76	$172.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $369.83 / $546.54 / $728.16	Professional		$369.83	$546.54	$728.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $159.31 / $216.26 / $326.01	Professional	26	$159.31	$216.26	$326.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $207.37 / $310.06 / $470.30	Professional	TC	$207.37	$310.06	$470.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $447.33	Professional		$32.34	$32.34	$447.33
United Facility/Professional Professional Modifier Low / Median / High Price $322.79 / $405.35 / $566.66	Professional		$322.79	$405.35	$566.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $138.91 / $161.82 / $228.99	Professional	26	$138.91	$161.82	$228.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $184.55 / $233.64 / $332.67	Professional	TC	$184.55	$233.64	$332.67