Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $85.03 / $119.30	Facility	26	$52.19	$85.03	$119.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.11 / $308.00 / $531.45	Professional		$171.11	$308.00	$531.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.19 / $63.15 / $145.11	Professional	26	$52.19	$63.15	$145.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.92 / $225.45 / $448.11	Professional	TC	$118.92	$225.45	$448.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $49.56 / $92.56	Professional	26	$39.65	$49.56	$92.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.79 / $298.79 / $452.12	Professional		$227.79	$298.79	$452.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.49 / $75.25 / $112.76	Professional	26	$62.49	$75.25	$112.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $166.67 / $222.23 / $329.61	Professional	TC	$166.67	$222.23	$329.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.87 / $79.45 / $237.44	Professional		$54.87	$79.45	$237.44
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 $215.52 / $391.79 / $679.40	Professional		$215.52	$391.79	$679.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.02 / $96.68 / $145.54	Professional	26	$60.02	$96.68	$145.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.94 / $293.95 / $538.92	Professional	TC	$151.94	$293.95	$538.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $208.42	Professional		$32.34	$32.34	$208.42
United Facility/Professional Professional Modifier Low / Median / High Price $209.19 / $285.62 / $406.47	Professional		$209.19	$285.62	$406.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.24 / $66.62 / $109.69	Professional	26	$52.24	$66.62	$109.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.68 / $220.04 / $331.07	Professional	TC	$151.68	$220.04	$331.07