Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.14 / $61.78 / $61.78	Facility	26	$59.14	$61.78	$61.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.18 / $404.80 / $498.44	Professional		$347.18	$404.80	$498.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $60.75 / $73.68	Professional	26	$53.19	$60.75	$73.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $173.59 / $199.98 / $244.85	Professional	52	$173.59	$199.98	$244.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.50 / $345.66 / $430.20	Professional	TC	$290.50	$345.66	$430.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $355.15 / $449.75 / $642.25	Professional		$355.15	$449.75	$642.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $61.75 / $86.56	Professional	26	$52.48	$61.75	$86.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $299.13 / $388.01 / $554.89	Professional	TC	$299.13	$388.01	$554.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $332.98 / $464.23	Professional		$56.97	$332.98	$464.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $405.36 / $571.25 / $1,068.04	Professional		$405.36	$571.25	$1,068.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.34 / $90.31 / $145.63	Professional	26	$62.34	$90.31	$145.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.85 / $459.55 / $852.14	Professional	TC	$331.85	$459.55	$852.14
United Facility/Professional Professional Modifier Low / Median / High Price $368.73 / $501.65 / $815.54	Professional		$368.73	$501.65	$815.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.15 / $72.20 / $117.20	Professional	26	$52.15	$72.20	$117.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $314.05 / $417.13 / $689.44	Professional	TC	$314.05	$417.13	$689.44