Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $62.62 / $98.96	Facility	26	$52.19	$62.62	$98.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.49 / $258.18 / $458.16	Professional		$144.49	$258.18	$458.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.19 / $62.26 / $170.57	Professional	26	$52.19	$62.26	$170.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.30 / $175.62 / $379.60	Professional	TC	$92.30	$175.62	$379.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.96 / $111.96 / $111.96	Professional		$111.96	$111.96	$111.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $40.24 / $62.08	Professional	26	$39.65	$40.24	$62.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.37 / $256.31 / $348.38	Professional		$188.37	$256.31	$348.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.22 / $70.86 / $100.16	Professional	26	$59.22	$70.86	$100.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $127.59 / $184.35 / $263.63	Professional	TC	$127.59	$184.35	$263.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.63 / $103.51 / $190.29	Professional		$54.63	$103.51	$190.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $60.98	Facility	26	$60.98	$60.98	$60.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.76 / $324.77 / $594.96	Professional		$181.76	$324.77	$594.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.59 / $86.51 / $147.18	Professional	26	$56.59	$86.51	$147.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.92 / $250.82 / $467.22	Professional	TC	$117.92	$250.82	$467.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $176.70	Professional		$32.34	$32.34	$176.70
United Facility/Professional Professional Modifier Low / Median / High Price $154.11 / $237.47 / $347.37	Professional		$154.11	$237.47	$347.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.46 / $63.76 / $94.13	Professional	26	$51.46	$63.76	$94.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.64 / $167.82 / $277.54	Professional	TC	$96.64	$167.82	$277.54