Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.34 / $79.23 / $112.70	Facility	26	$59.34	$79.23	$112.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.36 / $232.78 / $392.75	Professional		$143.36	$232.78	$392.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.53 / $61.96 / $147.51	Professional	26	$58.53	$61.96	$147.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.02 / $159.63 / $291.63	Professional	TC	$84.02	$159.63	$291.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.09 / $56.36 / $70.64	Professional	26	$45.09	$56.36	$70.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.33 / $214.99 / $336.80	Professional		$166.33	$214.99	$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 $104.62 / $131.02 / $240.00	Professional	TC	$104.62	$131.02	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.16 / $97.89 / $188.75	Professional		$62.16	$97.89	$188.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.44 / $69.44 / $69.44	Facility	26	$69.44	$69.44	$69.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.56 / $296.26 / $489.43	Professional		$179.56	$296.26	$489.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.22 / $90.80 / $145.52	Professional	26	$56.22	$90.80	$145.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.62 / $214.94 / $363.77	Professional	TC	$107.62	$214.94	$363.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $175.27	Professional		$32.34	$32.34	$175.27
United Facility/Professional Professional Modifier Low / Median / High Price $148.86 / $227.69 / $316.81	Professional		$148.86	$227.69	$316.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.81 / $68.98 / $98.52	Professional	26	$56.81	$68.98	$98.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.31 / $152.12 / $226.15	Professional	TC	$87.31	$152.12	$226.15