Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.68 / $56.68 / $100.66	Facility	26	$56.68	$56.68	$100.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.18 / $441.00 / $734.58	Professional		$347.18	$441.00	$734.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.55 / $65.43 / $100.66	Professional	26	$56.55	$65.43	$100.66
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $173.59 / $213.05 / $274.57	Professional	52	$173.59	$213.05	$274.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.50 / $378.40 / $652.12	Professional	TC	$290.50	$378.40	$652.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $355.15 / $417.83 / $648.25	Professional		$355.15	$417.83	$648.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $65.93 / $93.43	Professional	26	$52.48	$65.93	$93.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $299.13 / $351.92 / $560.91	Professional	TC	$299.13	$351.92	$560.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $78.62 / $521.25	Professional		$59.64	$78.62	$521.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.31 / $67.31 / $67.31	Facility	26	$67.31	$67.31	$67.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $366.87 / $584.44 / $918.61	Professional		$366.87	$584.44	$918.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.10 / $94.54 / $154.18	Professional	26	$56.10	$94.54	$154.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $308.41 / $484.41 / $763.13	Professional	TC	$308.41	$484.41	$763.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $119.04 / $311.66	Professional		$32.34	$119.04	$311.66
United Facility/Professional Professional Modifier Low / Median / High Price $367.98 / $529.85 / $770.55	Professional		$367.98	$529.85	$770.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.71 / $86.94 / $128.74	Professional	26	$60.71	$86.94	$128.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $307.05 / $437.54 / $650.60	Professional	TC	$307.05	$437.54	$650.60