Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.51 / $54.51 / $83.76	Facility	26	$54.51	$54.51	$83.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.63 / $161.91 / $259.95	Professional		$140.63	$161.91	$259.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $54.51 / $69.95	Professional	26	$51.50	$54.51	$69.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.45 / $105.00 / $208.44	Professional	TC	$88.45	$105.00	$208.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.22 / $62.08 / $88.03	Professional	26	$45.22	$62.08	$88.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.37 / $274.42 / $425.35	Professional		$169.37	$274.42	$425.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.89 / $73.40 / $105.49	Professional	26	$57.89	$73.40	$105.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $108.89 / $201.02 / $311.58	Professional	TC	$108.89	$201.02	$311.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.66 / $95.81 / $184.49	Professional		$52.66	$95.81	$184.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $61.34	Facility	26	$61.34	$61.34	$61.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.01 / $304.39 / $540.70	Professional		$146.01	$304.39	$540.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.86 / $70.26 / $120.00	Professional	26	$50.86	$70.26	$120.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.54 / $206.44 / $422.12	Professional	TC	$93.54	$206.44	$422.12
United Facility/Professional Professional Modifier Low / Median / High Price $145.16 / $223.12 / $397.21	Professional		$145.16	$223.12	$397.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.56 / $60.85 / $112.42	Professional	26	$49.56	$60.85	$112.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.57 / $161.05 / $291.31	Professional	TC	$95.57	$161.05	$291.31