Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.86 / $59.58 / $81.31	Facility	26	$44.86	$59.58	$81.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $252.59 / $411.75	Professional		$206.63	$252.59	$411.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $47.09 / $81.31	Professional	26	$44.14	$47.09	$81.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $208.45 / $330.23	Professional	TC	$162.49	$208.45	$330.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.03 / $197.14 / $347.28	Professional		$150.03	$197.14	$347.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.63 / $47.40 / $70.70	Professional	26	$37.63	$47.40	$70.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.38 / $148.41 / $274.77	Professional	TC	$112.38	$148.41	$274.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.78 / $60.38 / $349.50	Professional		$47.78	$60.38	$349.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $52.19 / $52.19	Facility	26	$52.19	$52.19	$52.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.68 / $341.24 / $616.08	Professional		$247.68	$341.24	$616.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.49 / $61.22 / $97.43	Professional	26	$43.49	$61.22	$97.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.52 / $286.73 / $529.28	Professional	TC	$203.52	$286.73	$529.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $165.17	Professional		$32.34	$32.34	$165.17
United Facility/Professional Professional Modifier Low / Median / High Price $242.37 / $351.79 / $516.95	Professional		$242.37	$351.79	$516.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.60 / $56.89 / $91.22	Professional	26	$41.60	$56.89	$91.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.26 / $274.64 / $410.53	Professional	TC	$200.26	$274.64	$410.53