Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.45 / $73.95 / $108.18	Facility	26	$55.45	$73.95	$108.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.96 / $375.00 / $598.50	Professional		$203.96	$375.00	$598.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.45 / $101.66 / $291.44	Professional	26	$55.45	$101.66	$291.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.51 / $294.04 / $441.00	Professional	TC	$148.51	$294.04	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.03 / $286.44 / $286.44	Professional		$158.03	$286.44	$286.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.99 / $49.48 / $65.61	Professional	26	$41.99	$49.48	$65.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.31 / $357.71 / $506.41	Professional		$269.31	$357.71	$506.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.49 / $66.47 / $97.28	Professional	26	$56.49	$66.47	$97.28
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 $57.74 / $159.24 / $267.33	Professional		$57.74	$159.24	$267.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.38 / $581.54 / $1,023.87	Professional		$257.38	$581.54	$1,023.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.29 / $88.63 / $136.03	Professional	26	$52.29	$88.63	$136.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.12 / $494.46 / $914.62	Professional	TC	$190.12	$494.46	$914.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $379.68	Professional		$32.34	$32.34	$379.68
United Facility/Professional Professional Modifier Low / Median / High Price $224.12 / $373.53 / $617.66	Professional		$224.12	$373.53	$617.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.08 / $62.21 / $88.46	Professional	26	$53.08	$62.21	$88.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.27 / $281.50 / $574.41	Professional	TC	$163.27	$281.50	$574.41