Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $19.05 / $19.05	Facility	26	$19.05	$19.05	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $74.13	Professional		$40.74	$53.70	$74.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.95 / $25.70	Professional	26	$15.14	$19.95	$25.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.11 / $47.86	Professional	TC	$25.70	$33.11	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $57.54	Professional		$54.95	$54.95	$57.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $20.42 / $21.38	Professional	26	$20.42	$20.42	$21.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $35.48	Professional	TC	$33.88	$33.88	$35.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $64.57 / $75.86	Professional		$27.54	$64.57	$75.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $38.02 / $54.95	Facility	26	$8.13	$38.02	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $50.12 / $309.03	Professional		$28.18	$50.12	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $24.55 / $114.82	Professional	26	$11.48	$24.55	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $41.69 / $194.98	Professional	TC	$18.20	$41.69	$194.98
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 $43.65 / $67.61 / $117.49	Professional		$43.65	$67.61	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $26.92 / $45.71	Professional	26	$16.60	$26.92	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $41.69 / $75.86	Professional	TC	$27.54	$41.69	$75.86