Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.54 / $35.54 / $35.54	Facility	26	$35.54	$35.54	$35.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.86 / $133.56 / $190.45	Professional		$99.86	$133.56	$190.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.08 / $39.99 / $53.69	Professional	26	$35.08	$39.99	$53.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $604.69 / $604.69 / $604.69	Professional	50	$604.69	$604.69	$604.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.81 / $84.40 / $105.65	Professional	TC	$66.81	$84.40	$105.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.75 / $140.87 / $181.34	Professional		$100.75	$140.87	$181.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.45 / $44.07 / $62.57	Professional	26	$37.45	$44.07	$62.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $151.13 / $211.31 / $272.01	Professional	50	$151.13	$211.31	$272.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.19 / $81.48 / $113.68	Professional	TC	$65.19	$81.48	$113.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.98 / $118.85 / $177.98	Professional		$40.98	$118.85	$177.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.14 / $47.14 / $47.14	Facility	26	$47.14	$47.14	$47.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.22 / $158.25 / $256.27	Professional		$106.22	$158.25	$256.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.03 / $50.69 / $91.49	Professional	26	$39.03	$50.69	$91.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.67 / $104.31 / $172.20	Professional	TC	$63.67	$104.31	$172.20
United Facility/Professional Professional Modifier Low / Median / High Price $92.44 / $121.24 / $181.87	Professional		$92.44	$121.24	$181.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.09 / $45.92 / $70.19	Professional	26	$38.09	$45.92	$70.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.68 / $71.50 / $114.00	Professional	TC	$53.68	$71.50	$114.00