Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.52 / $42.31 / $53.69	Facility	26	$35.52	$42.31	$53.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.84 / $146.91 / $267.42	Professional		$112.84	$146.91	$267.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.08 / $45.10 / $93.79	Professional	26	$35.08	$45.10	$93.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.04 / $95.27 / $200.77	Professional	TC	$75.04	$95.27	$200.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.97 / $110.56 / $183.63	Professional		$93.97	$110.56	$183.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.94 / $44.15 / $70.20	Professional	26	$36.94	$44.15	$70.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $140.96 / $165.84 / $275.44	Professional	50	$140.96	$165.84	$275.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.44 / $67.44 / $121.44	Professional	TC	$56.44	$67.44	$121.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.13 / $113.22 / $191.66	Professional		$44.13	$113.22	$191.66
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 / $156.12 / $278.92	Professional		$106.22	$156.12	$278.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.28 / $59.19 / $95.77	Professional	26	$39.28	$59.19	$95.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.41 / $103.87 / $180.94	Professional	TC	$60.41	$103.87	$180.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $32.34 / $71.06	Professional		$29.13	$32.34	$71.06
United Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $114.43 / $165.77	Professional		$87.76	$114.43	$165.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $44.03 / $62.13	Professional	26	$36.54	$44.03	$62.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.82 / $67.48 / $105.88	Professional	TC	$49.82	$67.48	$105.88