Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.71 / $87.67 / $122.30	Facility	26	$58.71	$87.67	$122.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.56 / $249.57 / $634.57	Professional		$175.56	$249.57	$634.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.71 / $61.28 / $93.15	Professional	26	$58.71	$61.28	$93.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.85 / $158.66 / $473.68	Professional	TC	$116.85	$158.66	$473.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.08 / $69.53 / $69.53	Professional	26	$50.08	$69.53	$69.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.87 / $297.17 / $407.37	Professional		$222.87	$297.17	$407.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.81 / $76.98 / $112.58	Professional	26	$64.81	$76.98	$112.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.54 / $224.64 / $318.39	Professional	TC	$157.54	$224.64	$318.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $88.99 / $229.61	Professional		$60.29	$88.99	$229.61
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 $220.01 / $393.78 / $709.11	Professional		$220.01	$393.78	$709.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.60 / $95.57 / $160.61	Professional	26	$61.60	$95.57	$160.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.87 / $314.94 / $584.10	Professional	TC	$148.87	$314.94	$584.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $213.21	Professional		$32.34	$32.34	$213.21
United Facility/Professional Professional Modifier Low / Median / High Price $186.11 / $310.19 / $435.93	Professional		$186.11	$310.19	$435.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.64 / $71.40 / $97.56	Professional	26	$58.64	$71.40	$97.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.91 / $244.91 / $328.68	Professional	TC	$129.91	$244.91	$328.68