Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $60.26 / $63.10	Facility	26	$57.54	$60.26	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $275.42 / $501.19	Professional		$186.21	$275.42	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $194.98	Professional	26	$54.95	$72.44	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $194.98 / $354.81	Professional	TC	$131.83	$194.98	$354.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $177.83 / $181.97	Professional		$147.91	$177.83	$181.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $58.88 / $93.33	Professional	26	$44.67	$58.88	$93.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $251.19 / $302.00	Professional	TC	$251.19	$251.19	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $295.12 / $549.54	Professional		$257.04	$295.12	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $75.86 / $125.89	Professional	26	$70.79	$75.86	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $218.78 / $416.87	Professional	TC	$190.55	$218.78	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $131.83 / $234.42	Professional		$60.26	$131.83	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $95.50	Facility	26	$14.45	$67.61	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $501.19 / $1,778.28	Professional		$234.42	$501.19	$1,778.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $117.49 / $323.59	Professional	26	$60.26	$117.49	$323.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $398.11 / $1,148.15	Professional	TC	$158.49	$398.11	$1,148.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $245.47	Professional		$32.36	$33.11	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $363.08 / $501.19	Professional		$208.93	$363.08	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $70.79 / $117.49	Professional	26	$60.26	$70.79	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $288.40 / $407.38	Professional	TC	$144.54	$288.40	$407.38