Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.37 / $55.37 / $70.92	Facility	26	$55.37	$55.37	$70.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.31 / $381.95 / $714.81	Professional		$316.31	$381.95	$714.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $264.98 / $328.17 / $618.89	Professional	TC	$264.98	$328.17	$618.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.13 / $305.37 / $462.95	Professional		$182.13	$305.37	$462.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.40 / $233.29 / $397.84	Professional	TC	$95.40	$233.29	$397.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.27 / $72.52 / $502.98	Professional		$50.27	$72.52	$502.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.00 / $392.06 / $692.89	Professional		$229.00	$392.06	$692.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.07 / $313.30 / $576.95	Professional	TC	$161.07	$313.30	$576.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $37.19 / $101.10	Professional		$32.34	$37.19	$101.10
United Facility/Professional Professional Modifier Low / Median / High Price $208.81 / $363.74 / $740.02	Professional		$208.81	$363.74	$740.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.35 / $297.67 / $614.58	Professional	TC	$154.35	$297.67	$614.58