Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.34 / $63.89 / $113.29	Facility	26	$59.34	$63.89	$113.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.05 / $237.90 / $433.16	Professional		$151.05	$237.90	$433.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.53 / $64.83 / $176.88	Professional	26	$58.53	$64.83	$176.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.71 / $175.05 / $310.11	Professional	TC	$91.71	$175.05	$310.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.16 / $124.48 / $128.26	Professional		$117.16	$124.48	$128.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.81 / $67.63 / $79.11	Professional	26	$45.81	$67.63	$79.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.98 / $85.98 / $85.98	Professional	TC	$85.98	$85.98	$85.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.33 / $219.09 / $336.80	Professional		$166.33	$219.09	$336.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.17 / $70.79 / $107.44	Professional	26	$60.17	$70.79	$107.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $106.16 / $134.01 / $240.00	Professional	TC	$106.16	$134.01	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $107.48 / $199.49	Professional		$64.84	$107.48	$199.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.79 / $69.79 / $69.79	Facility	26	$69.79	$69.79	$69.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.12 / $332.19 / $586.75	Professional		$190.12	$332.19	$586.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.94 / $90.34 / $145.52	Professional	26	$55.94	$90.34	$145.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.73 / $245.19 / $456.20	Professional	TC	$119.73	$245.19	$456.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $185.24	Professional		$32.34	$32.34	$185.24
United Facility/Professional Professional Modifier Low / Median / High Price $183.20 / $241.49 / $362.77	Professional		$183.20	$241.49	$362.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.86 / $66.31 / $97.98	Professional	26	$55.86	$66.31	$97.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.90 / $169.59 / $277.16	Professional	TC	$116.90	$169.59	$277.16