Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.42 / $93.42 / $93.42	Facility	26	$93.42	$93.42	$93.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.95 / $178.17 / $186.32	Professional		$166.95	$178.17	$186.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.82 / $93.07 / $99.94	Professional	26	$92.82	$93.07	$99.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.87 / $81.26 / $86.38	Professional	TC	$73.87	$81.26	$86.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.06 / $156.47 / $381.90	Professional		$109.06	$156.47	$381.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.59 / $118.74 / $214.03	Professional	26	$68.59	$118.74	$214.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.08 / $37.74 / $160.02	Professional	TC	$32.08	$37.74	$160.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $119.90 / $155.16 / $296.87	Professional		$119.90	$155.16	$296.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.13 / $138.13 / $138.13	Facility	26	$138.13	$138.13	$138.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.87 / $243.53 / $480.00	Professional		$108.87	$243.53	$480.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.13 / $171.24 / $292.83	Professional	26	$56.13	$171.24	$292.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.40 / $95.44 / $223.20	Professional	TC	$52.40	$95.44	$223.20
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 $149.52 / $256.33 / $366.30	Professional		$149.52	$256.33	$366.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.51 / $134.79 / $231.59	Professional	26	$106.51	$134.79	$231.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.79 / $106.47 / $184.06	Professional	TC	$81.79	$106.47	$184.06