Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.01 / $82.43 / $121.74	Facility	26	$62.01	$82.43	$121.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.25 / $362.54 / $608.00	Professional		$215.25	$362.54	$608.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.01 / $85.00 / $154.00	Professional	26	$62.01	$85.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.24 / $241.35 / $368.50	Professional	TC	$153.24	$241.35	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $69.27 / $110.06	Professional	26	$47.14	$69.27	$110.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.67 / $365.88 / $502.77	Professional		$282.67	$365.88	$502.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.90 / $74.30 / $103.88	Professional	26	$59.90	$74.30	$103.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $212.07 / $291.24 / $400.00	Professional	TC	$212.07	$291.24	$400.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $64.01 / $97.45 / $298.05	Professional		$64.01	$97.45	$298.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.52 / $523.40 / $964.61	Professional		$270.52	$523.40	$964.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $95.28 / $152.66	Professional	26	$58.77	$95.28	$152.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.91 / $427.29 / $831.75	Professional	TC	$194.91	$427.29	$831.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $314.84	Professional		$32.34	$32.34	$314.84
United Facility/Professional Professional Modifier Low / Median / High Price $236.43 / $406.12 / $607.23	Professional		$236.43	$406.12	$607.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.65 / $72.36 / $98.94	Professional	26	$58.65	$72.36	$98.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $170.80 / $292.14 / $526.69	Professional	TC	$170.80	$292.14	$526.69