Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.89 / $53.57 / $95.17	Facility	26	$49.89	$53.57	$95.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.96 / $145.74 / $275.00	Professional		$130.96	$145.74	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $54.53 / $115.51	Professional	26	$48.28	$54.53	$115.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.06 / $94.04 / $154.18	Professional	TC	$81.06	$94.04	$154.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.36 / $136.69 / $184.86	Professional		$101.36	$136.69	$184.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.88 / $41.29 / $61.71	Professional	26	$37.88	$41.29	$61.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $75.77 / $75.77 / $75.77	Professional	TC	$75.77	$75.77	$75.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.67 / $123.36 / $157.93	Professional		$108.67	$123.36	$157.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.76 / $46.27 / $55.12	Professional	26	$40.76	$46.27	$55.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.91 / $77.09 / $100.95	Professional	TC	$67.91	$77.09	$100.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.45 / $94.71 / $172.54	Professional		$52.45	$94.71	$172.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.64 / $58.64 / $58.64	Facility	26	$58.64	$58.64	$58.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.10 / $198.46 / $322.14	Professional		$125.10	$198.46	$322.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.00 / $73.98 / $120.53	Professional	26	$47.00	$73.98	$120.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.09 / $124.08 / $201.62	Professional	TC	$78.09	$124.08	$201.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $120.73	Professional		$32.34	$32.34	$120.73
United Facility/Professional Professional Modifier Low / Median / High Price $136.97 / $157.80 / $222.92	Professional		$136.97	$157.80	$222.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.49 / $56.24 / $81.75	Professional	26	$49.49	$56.24	$81.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.61 / $103.57 / $155.36	Professional	TC	$87.61	$103.57	$155.36