Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $72.44 / $123.03	Facility	26	$67.61	$72.44	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $398.11 / $831.76	Professional		$257.04	$398.11	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $112.20 / $190.55	Professional	26	$67.61	$112.20	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $281.84 / $501.19	Professional	TC	$186.21	$281.84	$501.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	26	$158.49	$158.49	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $338.84 / $660.69	Professional		$323.59	$338.84	$660.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $81.28 / $134.90	Professional	26	$77.62	$81.28	$134.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $251.19 / $512.86	Professional	TC	$239.88	$251.19	$512.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $87.10 / $102.33	Professional		$64.57	$87.10	$102.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $616.60 / $2,187.76	Professional		$323.59	$616.60	$2,187.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $128.82 / $354.81	Professional	26	$67.61	$128.82	$354.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $501.19 / $1,412.54	Professional	TC	$234.42	$501.19	$1,412.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $316.23	Professional		$32.36	$33.11	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $436.52 / $602.56	Professional		$281.84	$436.52	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $75.86 / $112.20	Professional	26	$66.07	$75.86	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $354.81 / $501.19	Professional	TC	$208.93	$354.81	$501.19