Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $165.00 / $165.00	Facility		$18.62	$165.00	$165.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.45 / $2.45 / $2.45	Facility	26	$2.45	$2.45	$2.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.82 / $23.83 / $39.84	Professional		$17.82	$23.83	$39.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.45 / $2.92 / $4.53	Professional	26	$2.45	$2.92	$4.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.17 / $9.44 / $12.94	Professional	52	$9.17	$9.44	$12.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.74 / $18.35 / $26.21	Professional	TC	$15.74	$18.35	$26.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.10 / $165.00 / $165.00	Facility		$33.10	$165.00	$165.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.63 / $33.10 / $51.30	Professional		$21.63	$33.10	$51.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.28 / $8.60 / $12.32	Professional	26	$3.28	$8.60	$12.32
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $32.44 / $49.65 / $76.95	Professional	50	$32.44	$49.65	$76.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $24.50 / $39.20	Professional	TC	$18.35	$24.50	$39.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2.94 / $20.42 / $28.31	Facility		$2.94	$20.42	$28.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2.94 / $20.42 / $27.57	Professional		$2.94	$20.42	$27.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $165.00 / $165.00	Facility		$165.00	$165.00	$165.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.85 / $37.65 / $73.56	Professional		$20.85	$37.65	$73.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.98 / $7.92 / $16.79	Professional	26	$2.98	$7.92	$16.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.82 / $30.71 / $50.28	Professional	TC	$17.82	$30.71	$50.28
United Facility/Professional Professional Modifier Low / Median / High Price $19.12 / $26.86 / $51.52	Professional		$19.12	$26.86	$51.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.83 / $3.68 / $12.29	Professional	26	$2.83	$3.68	$12.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.14 / $20.61 / $35.25	Professional	TC	$16.14	$20.61	$35.25