Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.88 / $94.31 / $114.77	Facility	26	$84.88	$94.31	$114.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $682.87 / $758.75 / $970.25	Professional		$682.87	$758.75	$970.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.88 / $92.77 / $114.77	Professional	26	$84.88	$92.77	$114.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $597.99 / $664.44 / $855.48	Professional	TC	$597.99	$664.44	$855.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $674.96 / $695.21 / $918.97	Professional		$674.96	$695.21	$918.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $82.24 / $106.37	Professional	26	$79.84	$82.24	$106.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $595.12 / $612.97 / $812.60	Professional	TC	$595.12	$612.97	$812.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.11 / $147.94 / $1,201.38	Professional		$103.11	$147.94	$1,201.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.04 / $110.04 / $110.04	Facility	26	$110.04	$110.04	$110.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $861.73 / $1,456.96 / $3,746.54	Professional		$861.73	$1,456.96	$3,746.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.67 / $176.25 / $445.90	Professional	26	$97.67	$176.25	$445.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $764.06 / $1,280.71 / $3,300.64	Professional	TC	$764.06	$1,280.71	$3,300.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $759.39	Professional		$32.34	$32.34	$759.39
United Facility/Professional Professional Modifier Low / Median / High Price $831.40 / $1,033.73 / $1,266.83	Professional		$831.40	$1,033.73	$1,266.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.98 / $115.39 / $199.48	Professional	26	$99.98	$115.39	$199.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $730.84 / $910.17 / $1,131.52	Professional	TC	$730.84	$910.17	$1,131.52