Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $79.43 / $102.33	Facility	26	$54.95	$79.43	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $371.54 / $660.69	Professional		$218.78	$371.54	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $93.33 / $165.96	Professional	26	$54.95	$93.33	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $257.04 / $501.19	Professional	TC	$162.18	$257.04	$501.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $53.70 / $79.43	Professional	26	$41.69	$53.70	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $354.81 / $676.08	Professional		$309.03	$354.81	$676.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $66.07 / $109.65	Professional	26	$63.10	$66.07	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $288.40 / $602.56	Professional	TC	$245.47	$288.40	$602.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $85.11	Professional		$52.48	$70.79	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $93.33	Facility	26	$13.80	$64.57	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $645.65 / $2,089.30	Professional		$269.15	$645.65	$2,089.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $104.71 / $281.84	Professional	26	$54.95	$104.71	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $524.81 / $1,737.80	Professional	TC	$190.55	$524.81	$1,737.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $380.19	Professional		$32.36	$33.11	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $446.68 / $616.60	Professional		$223.87	$446.68	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $93.33	Professional	26	$53.70	$61.66	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $389.05 / $549.54	Professional	TC	$165.96	$389.05	$549.54