Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.59 / $118.51 / $176.67	Facility	26	$81.59	$118.51	$176.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.20 / $138.38 / $236.17	Professional		$124.20	$138.38	$236.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.60 / $48.90 / $92.77	Professional	TC	$42.60	$48.90	$92.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.65 / $188.21 / $300.00	Professional		$152.65	$188.21	$300.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.02 / $58.09 / $116.91	Professional	TC	$45.02	$58.09	$116.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.56 / $75.41 / $184.21	Professional		$52.56	$75.41	$184.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.07 / $106.07 / $106.07	Facility	26	$106.07	$106.07	$106.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.42 / $235.18 / $359.77	Professional		$170.42	$235.18	$359.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.58 / $87.64 / $174.26	Professional	TC	$60.58	$87.64	$174.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $144.74	Professional		$32.34	$32.34	$144.74
United Facility/Professional Professional Modifier Low / Median / High Price $127.94 / $174.84 / $213.67	Professional		$127.94	$174.84	$213.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.52 / $66.76 / $89.67	Professional	TC	$43.52	$66.76	$89.67