Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.04 / $79.04 / $101.70	Facility	26	$79.04	$79.04	$101.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $152.77 / $514.00	Professional		$130.08	$152.77	$514.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.72 / $80.56 / $124.21	Professional	26	$72.72	$80.56	$124.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $73.73 / $130.10	Professional	TC	$55.03	$73.73	$130.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.83 / $153.26 / $214.73	Professional		$114.83	$153.26	$214.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $84.03 / $134.40	Professional	26	$69.08	$84.03	$134.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.80 / $58.85 / $103.20	Professional	TC	$30.80	$58.85	$103.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.22 / $95.46 / $192.18	Professional		$70.22	$95.46	$192.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $91.04 / $91.04	Facility	26	$91.04	$91.04	$91.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.40 / $183.52 / $304.66	Professional		$122.40	$183.52	$304.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.87 / $111.39 / $167.30	Professional	26	$75.87	$111.39	$167.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.54 / $70.08 / $151.97	Professional	TC	$33.54	$70.08	$151.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.23 / $50.20 / $101.92	Professional		$20.23	$50.20	$101.92
United Facility/Professional Professional Modifier Low / Median / High Price $110.74 / $166.86 / $328.92	Professional		$110.74	$166.86	$328.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.42 / $96.19 / $166.08	Professional	26	$69.42	$96.19	$166.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.02 / $78.81 / $162.25	Professional	TC	$34.02	$78.81	$162.25