Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.41 / $89.45 / $111.50	Facility	26	$58.41	$89.45	$111.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.52 / $215.27 / $412.52	Professional		$199.52	$215.27	$412.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.41 / $60.96 / $90.99	Professional	26	$58.41	$60.96	$90.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.11 / $154.31 / $306.18	Professional	TC	$141.11	$154.31	$306.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $55.44 / $55.44 / $55.44	Professional	26	$55.44	$55.44	$55.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.06 / $329.95 / $492.92	Professional		$255.06	$329.95	$492.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.12 / $78.73 / $117.12	Professional	26	$66.12	$78.73	$117.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $187.37 / $249.83 / $364.75	Professional	TC	$187.37	$249.83	$364.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.96 / $91.77 / $277.05	Professional		$63.96	$91.77	$277.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.47 / $453.65 / $772.65	Professional		$251.47	$453.65	$772.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.85 / $101.16 / $163.81	Professional	26	$62.85	$101.16	$163.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $180.33 / $335.69 / $617.70	Professional	TC	$180.33	$335.69	$617.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $242.35	Professional		$32.34	$32.34	$242.35
United Facility/Professional Professional Modifier Low / Median / High Price $226.39 / $335.55 / $508.92	Professional		$226.39	$335.55	$508.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $73.19 / $99.71	Professional	26	$59.82	$73.19	$99.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.25 / $251.56 / $388.51	Professional	TC	$168.25	$251.56	$388.51