Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.81 / $59.08 / $72.67	Facility	26	$57.81	$59.08	$72.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.54 / $157.08 / $280.63	Professional		$153.54	$157.08	$280.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $58.93 / $90.03	Professional	26	$53.70	$58.93	$90.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.29 / $102.06 / $199.30	Professional	TC	$96.29	$102.06	$199.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.26 / $151.57 / $302.17	Professional		$117.26	$151.57	$302.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $58.08 / $84.36	Professional	26	$45.95	$58.08	$84.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.31 / $93.48 / $227.52	Professional	TC	$71.31	$93.48	$227.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.77 / $85.94 / $417.16	Professional		$61.77	$85.94	$417.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.70 / $66.70 / $66.70	Facility	26	$66.70	$66.70	$66.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.39 / $374.40 / $634.46	Professional		$270.39	$374.40	$634.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.17 / $75.09 / $120.30	Professional	26	$55.17	$75.09	$120.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.30 / $285.97 / $518.42	Professional	TC	$199.30	$285.97	$518.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $184.53	Professional		$32.34	$32.34	$184.53
United Facility/Professional Professional Modifier Low / Median / High Price $244.82 / $333.76 / $579.97	Professional		$244.82	$333.76	$579.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.28 / $68.80 / $118.53	Professional	26	$50.28	$68.80	$118.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $197.30 / $262.32 / $458.97	Professional	TC	$197.30	$262.32	$458.97