Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.71 / $78.79 / $112.06	Facility	26	$58.71	$78.79	$112.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.21 / $281.67 / $520.79	Professional		$165.21	$281.67	$520.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $61.28 / $172.44	Professional	26	$55.00	$61.28	$172.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.50 / $201.68 / $372.43	Professional	TC	$106.50	$201.68	$372.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.63 / $127.63 / $131.50	Professional		$127.63	$127.63	$131.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.72 / $59.40 / $69.88	Professional	26	$44.72	$59.40	$69.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.71 / $234.15 / $360.23	Professional		$177.71	$234.15	$360.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $70.37 / $104.21	Professional	26	$59.82	$70.37	$104.21
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $117.90 / $151.09 / $262.82	Professional	TC	$117.90	$151.09	$262.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $118.84 / $216.90	Professional		$62.30	$118.84	$216.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.35 / $360.67 / $597.97	Professional		$207.35	$360.67	$597.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.61 / $93.87 / $176.00	Professional	26	$55.61	$93.87	$176.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.83 / $273.32 / $473.65	Professional	TC	$135.83	$273.32	$473.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $201.41	Professional		$32.34	$32.34	$201.41
United Facility/Professional Professional Modifier Low / Median / High Price $171.25 / $277.98 / $406.39	Professional		$171.25	$277.98	$406.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.52 / $68.06 / $123.38	Professional	26	$56.52	$68.06	$123.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.75 / $200.54 / $290.48	Professional	TC	$115.75	$200.54	$290.48