Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.92 / $68.78 / $121.43	Facility	26	$63.92	$68.78	$121.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.74 / $281.16 / $704.39	Professional		$175.74	$281.16	$704.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $83.17 / $254.79	Professional	26	$62.95	$83.17	$254.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.82 / $211.54 / $402.87	Professional	TC	$111.82	$211.54	$402.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $143.96 / $180.01 / $180.01	Professional		$143.96	$180.01	$180.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.39 / $54.53 / $78.77	Professional	26	$48.39	$54.53	$78.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.60 / $259.50 / $387.99	Professional		$211.60	$259.50	$387.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.81 / $76.26 / $115.75	Professional	26	$64.81	$76.26	$115.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.83 / $190.00 / $264.92	Professional	TC	$144.83	$190.00	$264.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.53 / $125.20 / $230.22	Professional		$69.53	$125.20	$230.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $74.84	Facility	26	$74.84	$74.84	$74.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.37 / $357.09 / $585.79	Professional		$220.37	$357.09	$585.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.30 / $97.75 / $173.80	Professional	26	$60.30	$97.75	$173.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.72 / $255.81 / $451.00	Professional	TC	$142.72	$255.81	$451.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $213.77	Professional		$32.34	$32.34	$213.77
United Facility/Professional Professional Modifier Low / Median / High Price $188.67 / $265.23 / $367.42	Professional		$188.67	$265.23	$367.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.36 / $70.73 / $104.71	Professional	26	$60.36	$70.73	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.93 / $202.46 / $280.22	Professional	TC	$120.93	$202.46	$280.22