Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.15 / $73.95 / $103.45	Facility	26	$55.15	$73.95	$103.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.20 / $315.64 / $522.50	Professional		$215.20	$315.64	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $72.97 / $145.65	Professional	26	$55.15	$72.97	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $160.04 / $235.83 / $368.50	Professional	TC	$160.04	$235.83	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.61 / $65.61 / $65.61	Professional	26	$65.61	$65.61	$65.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.33 / $404.44 / $535.74	Professional		$303.33	$404.44	$535.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.50 / $66.48 / $97.28	Professional	26	$56.50	$66.48	$97.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $246.08 / $337.95 / $446.69	Professional	TC	$246.08	$337.95	$446.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.28 / $86.61 / $298.77	Professional		$60.28	$86.61	$298.77
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 $271.19 / $578.29 / $1,019.93	Professional		$271.19	$578.29	$1,019.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.29 / $88.63 / $150.00	Professional	26	$52.29	$88.63	$150.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.93 / $492.33 / $910.26	Professional	TC	$203.93	$492.33	$910.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $311.52	Professional		$32.34	$32.34	$311.52
United Facility/Professional Professional Modifier Low / Median / High Price $232.73 / $390.32 / $643.63	Professional		$232.73	$390.32	$643.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.43 / $61.56 / $92.03	Professional	26	$52.43	$61.56	$92.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.97 / $298.29 / $551.60	Professional	TC	$178.97	$298.29	$551.60