Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.79 / $57.42 / $102.62	Facility	26	$53.79	$57.42	$102.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.22 / $282.66 / $637.11	Professional		$158.22	$282.66	$637.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $66.63 / $217.21	Professional	26	$53.67	$66.63	$217.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.43 / $198.79 / $376.02	Professional	TC	$104.43	$198.79	$376.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.16 / $130.41 / $189.73	Professional		$63.16	$130.41	$189.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.90 / $51.13 / $82.98	Professional	26	$40.90	$51.13	$82.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.81 / $48.81 / $48.81	Professional	TC	$48.81	$48.81	$48.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.00 / $252.71 / $377.27	Professional		$202.00	$252.71	$377.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.48 / $68.80 / $101.91	Professional	26	$58.48	$68.80	$101.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.55 / $176.22 / $266.64	Professional	TC	$137.55	$176.22	$266.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.58 / $115.20 / $208.33	Professional		$56.58	$115.20	$208.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.24 / $63.24 / $63.24	Facility	26	$63.24	$63.24	$63.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.50 / $380.79 / $616.46	Professional		$199.50	$380.79	$616.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.15 / $87.83 / $143.68	Professional	26	$54.15	$87.83	$143.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.91 / $279.07 / $478.58	Professional	TC	$133.91	$279.07	$478.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $198.87	Professional		$32.34	$32.34	$198.87
United Facility/Professional Professional Modifier Low / Median / High Price $179.62 / $290.89 / $390.31	Professional		$179.62	$290.89	$390.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.23 / $63.88 / $106.92	Professional	26	$55.23	$63.88	$106.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.83 / $177.39 / $302.13	Professional	TC	$116.83	$177.39	$302.13