Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.05 / $18.05 / $18.05	Facility	26	$18.05	$18.05	$18.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.09 / $33.95 / $122.03	Professional		$31.09	$33.95	$122.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $18.92 / $33.47	Professional	26	$17.23	$18.92	$33.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.95 / $15.66 / $88.56	Professional	TC	$13.95	$15.66	$88.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $59.50 / $102.06	Professional		$39.90	$59.50	$102.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $31.00 / $44.02	Professional	26	$17.55	$31.00	$44.02
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $59.85 / $89.25 / $153.09	Professional	50	$59.85	$89.25	$153.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.34 / $28.60 / $66.62	Professional	TC	$22.34	$28.60	$66.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.45 / $23.59 / $44.15	Professional		$16.45	$23.59	$44.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.19 / $93.12 / $202.65	Professional		$39.19	$93.12	$202.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.75 / $35.75 / $64.34	Professional	26	$21.75	$35.75	$64.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.85 / $38.09 / $134.34	Professional	TC	$16.85	$38.09	$134.34
United Facility/Professional Professional Modifier Low / Median / High Price $36.57 / $47.88 / $151.59	Professional		$36.57	$47.88	$151.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.51 / $27.17 / $46.25	Professional	26	$20.51	$27.17	$46.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.75 / $19.07 / $104.98	Professional	TC	$14.75	$19.07	$104.98