Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.90 / $91.64 / $133.37	Facility	26	$67.90	$91.64	$133.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.20 / $292.77 / $545.47	Professional		$252.20	$292.77	$545.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.90 / $74.08 / $145.65	Professional	26	$67.90	$74.08	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $184.30 / $206.42 / $370.63	Professional	TC	$184.30	$206.42	$370.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.43 / $52.43 / $64.48	Professional	26	$52.43	$52.43	$64.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.18 / $336.28 / $509.50	Professional		$281.18	$336.28	$509.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.13 / $81.34 / $118.88	Professional	26	$69.13	$81.34	$118.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $212.05 / $249.48 / $400.00	Professional	TC	$212.05	$249.48	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $74.39 / $103.50 / $347.76	Professional		$74.39	$103.50	$347.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.91 / $79.91 / $79.91	Facility	26	$79.91	$79.91	$79.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.64 / $534.94 / $893.09	Professional		$315.64	$534.94	$893.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.59 / $103.79 / $166.29	Professional	26	$64.59	$103.79	$166.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $232.89 / $425.89 / $743.02	Professional	TC	$232.89	$425.89	$743.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $314.84	Professional		$32.34	$32.34	$314.84
United Facility/Professional Professional Modifier Low / Median / High Price $280.33 / $393.58 / $571.54	Professional		$280.33	$393.58	$571.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.45 / $79.03 / $106.11	Professional	26	$64.45	$79.03	$106.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.37 / $332.45 / $478.68	Professional	TC	$210.37	$332.45	$478.68