Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $54.00	Facility	26	$43.97	$43.97	$54.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $60.84 / $83.56	Professional		$55.57	$60.84	$83.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.02 / $43.97 / $56.03	Professional	26	$40.02	$43.97	$56.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.86 / $18.03 / $28.80	Professional	TC	$16.86	$18.03	$28.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.14 / $67.22 / $94.20	Professional		$57.14	$67.22	$94.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.28 / $48.56 / $67.61	Professional	26	$41.28	$48.56	$67.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.39 / $18.64 / $28.00	Professional	TC	$15.39	$18.64	$28.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.94 / $32.94 / $85.88	Professional		$18.94	$32.94	$85.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.32 / $52.32 / $52.32	Facility	26	$52.32	$52.32	$52.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.21 / $92.02 / $155.94	Professional		$62.21	$92.02	$155.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.20 / $66.13 / $112.24	Professional	26	$44.20	$66.13	$112.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.43 / $26.05 / $43.71	Professional	TC	$17.43	$26.05	$43.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $65.34	Professional		$32.34	$32.34	$65.34
United Facility/Professional Professional Modifier Low / Median / High Price $56.84 / $66.40 / $116.60	Professional		$56.84	$66.40	$116.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.70 / $50.68 / $67.83	Professional	26	$40.70	$50.68	$67.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.21 / $19.12 / $25.85	Professional	TC	$16.21	$19.12	$25.85