Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Facility	26	$25.12	$25.12	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $117.49	Professional		$69.18	$89.13	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $33.11	Professional	26	$19.95	$26.30	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $61.66 / $83.18	Professional	TC	$47.86	$61.66	$83.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $141.25 / $295.12	Professional		$134.90	$141.25	$295.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $47.86 / $100.00	Professional	26	$39.81	$47.86	$100.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $91.20 / $190.55	Professional	TC	$81.28	$91.20	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $104.71	Professional		$35.48	$42.66	$104.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $48.98 / $69.18	Facility	26	$10.47	$48.98	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $144.54 / $870.96	Professional		$48.98	$144.54	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $46.77 / $316.23	Professional	26	$15.14	$46.77	$316.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $102.33 / $575.44	Professional	TC	$33.88	$102.33	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $173.78 / $245.47	Professional		$104.71	$173.78	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $54.95 / $81.28	Professional	26	$33.88	$54.95	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $114.82 / $173.78	Professional	TC	$69.18	$114.82	$173.78