Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.36 / $18.32 / $18.32	Facility	26	$16.36	$18.32	$18.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.69 / $64.26 / $325.83	Professional		$29.69	$64.26	$325.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $26.63 / $107.15	Professional	26	$16.57	$26.63	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.33 / $15.81 / $106.68	Professional	TC	$13.33	$15.81	$106.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $66.15 / $181.71	Professional		$39.72	$66.15	$181.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.19 / $34.65 / $68.26	Professional	26	$23.19	$34.65	$68.26
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $59.58 / $99.23 / $272.56	Professional	50	$59.58	$99.23	$272.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.54 / $28.60 / $128.15	Professional	TC	$16.54	$28.60	$128.15
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 $36.88 / $68.14 / $179.12	Professional		$36.88	$68.14	$179.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.62 / $35.65 / $65.23	Professional	26	$20.62	$35.65	$65.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.83 / $29.50 / $124.69	Professional	TC	$15.83	$29.50	$124.69
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $48.85 / $201.45 / $201.45	Facility	26	$48.85	$201.45	$201.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $80.48 / $764.92	Professional		$38.29	$80.48	$764.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.11 / $30.35 / $382.94	Professional	26	$21.11	$30.35	$382.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $30.25 / $585.86	Professional	TC	$16.17	$30.25	$585.86
United Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $45.27 / $143.62	Professional		$35.72	$45.27	$143.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $25.85 / $53.09	Professional	26	$20.23	$25.85	$53.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.10 / $19.11 / $82.79	Professional	TC	$15.10	$19.11	$82.79