Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.21 / $258.05 / $280.22	Facility		$39.21	$258.05	$280.22
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.48 / $25.48 / $25.48	Facility	26	$25.48	$25.48	$25.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $53.95 / $109.37	Professional		$36.10	$53.95	$109.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.48 / $30.29 / $60.58	Professional	26	$25.48	$30.29	$60.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $56.53 / $115.29 / $115.29	Professional	50	$56.53	$115.29	$115.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.47 / $20.41 / $30.00	Professional	52	$19.47	$20.41	$30.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.72 / $18.96 / $59.03	Professional	TC	$13.72	$18.96	$59.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.49 / $84.49 / $163.07	Facility		$84.49	$84.49	$163.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.42 / $84.49 / $119.77	Professional		$63.42	$84.49	$119.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.91 / $28.14 / $41.09	Professional	26	$23.91	$28.14	$41.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $95.13 / $126.73 / $179.65	Professional	50	$95.13	$126.73	$179.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.51 / $56.35 / $77.76	Professional	TC	$35.51	$56.35	$77.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.89 / $33.31 / $58.23	Facility		$16.89	$33.31	$58.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.14 / $31.92 / $54.82	Professional		$16.14	$31.92	$54.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $52.57	Facility		$52.57	$52.57	$52.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.21 / $87.57 / $160.19	Professional		$48.21	$87.57	$160.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.46 / $34.11 / $63.28	Professional	26	$26.46	$34.11	$63.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.16 / $48.28 / $91.78	Professional	TC	$17.16	$48.28	$91.78
United Facility/Professional Professional Modifier Low / Median / High Price $53.99 / $79.39 / $112.48	Professional		$53.99	$79.39	$112.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.17 / $31.76 / $43.92	Professional	26	$26.17	$31.76	$43.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.99 / $42.42 / $70.34	Professional	TC	$26.99	$42.42	$70.34