Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $69.95 / $99.55	Facility	26	$52.19	$69.95	$99.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.63 / $221.50 / $429.12	Professional		$140.63	$221.50	$429.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $54.40 / $146.51	Professional	26	$51.50	$54.40	$146.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.45 / $139.30 / $302.37	Professional	TC	$88.45	$139.30	$302.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.56 / $62.08 / $62.08	Professional	26	$49.56	$62.08	$62.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.34 / $195.38 / $325.70	Professional		$148.34	$195.38	$325.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.95 / $62.29 / $92.74	Professional	26	$52.95	$62.29	$92.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.33 / $123.62 / $240.00	Professional	TC	$95.33	$123.62	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.82 / $80.48 / $187.07	Professional		$53.82	$80.48	$187.07
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 $176.45 / $298.29 / $509.03	Professional		$176.45	$298.29	$509.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.46 / $80.34 / $127.55	Professional	26	$49.46	$80.34	$127.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.96 / $220.07 / $393.97	Professional	TC	$112.96	$220.07	$393.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $172.64	Professional		$32.34	$32.34	$172.64
United Facility/Professional Professional Modifier Low / Median / High Price $150.91 / $227.03 / $330.43	Professional		$150.91	$227.03	$330.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.64 / $60.55 / $85.49	Professional	26	$49.64	$60.55	$85.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.65 / $179.78 / $233.35	Professional	TC	$96.65	$179.78	$233.35