Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.58 / $43.58 / $43.58	Facility	26	$43.58	$43.58	$43.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $405.26 / $420.55 / $464.40	Professional		$405.26	$420.55	$464.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.93 / $43.67 / $46.62	Professional	26	$41.93	$43.67	$46.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $336.19 / $376.97 / $417.78	Professional	TC	$336.19	$376.97	$417.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.92 / $354.19 / $507.64	Professional		$259.92	$354.19	$507.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.34 / $40.50 / $58.08	Professional	26	$24.34	$40.50	$58.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.58 / $313.70 / $449.59	Professional	TC	$235.58	$313.70	$449.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.76 / $118.67 / $740.06	Professional		$62.76	$118.67	$740.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.93 / $89.93 / $89.93	Facility	26	$89.93	$89.93	$89.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.75 / $427.58 / $841.20	Professional		$269.75	$427.58	$841.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.99 / $45.26 / $97.41	Professional	26	$26.99	$45.26	$97.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.73 / $379.06 / $757.14	Professional	TC	$236.73	$379.06	$757.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $337.74 / $531.11 / $884.01	Professional		$337.74	$531.11	$884.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $58.10 / $115.04	Professional	26	$51.30	$58.10	$115.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $288.67 / $476.24 / $820.41	Professional	TC	$288.67	$476.24	$820.41