Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.55 / $15.55 / $15.55	Facility	26	$15.55	$15.55	$15.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.63 / $68.70 / $144.84	Professional		$64.63	$68.70	$144.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.41 / $16.04 / $30.05	Professional	26	$15.41	$16.04	$30.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.08 / $50.94 / $114.80	Professional	TC	$49.08	$50.94	$114.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.42 / $17.42 / $88.32	Professional		$17.42	$17.42	$88.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $20.93 / $32.19	Professional	26	$12.09	$20.93	$32.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $6.93 / $8.16 / $60.56	Professional	TC	$6.93	$8.16	$60.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.73 / $36.52 / $113.44	Professional		$21.73	$36.52	$113.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.59 / $34.59 / $34.59	Facility	26	$34.59	$34.59	$34.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.78 / $90.47 / $138.84	Professional		$38.78	$90.47	$138.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $26.20 / $48.37	Professional	26	$9.27	$26.20	$48.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.50 / $66.06 / $100.38	Professional	TC	$29.50	$66.06	$100.38
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 $61.62 / $90.76 / $147.78	Professional		$61.62	$90.76	$147.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.77 / $23.10 / $43.98	Professional	26	$13.77	$23.10	$43.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.54 / $67.88 / $130.50	Professional	TC	$44.54	$67.88	$130.50