Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $49.74 / $87.65	Facility	26	$45.71	$49.74	$87.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.22 / $221.75 / $410.81	Professional		$123.22	$221.75	$410.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.25 / $52.62 / $168.86	Professional	26	$45.25	$52.62	$168.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.51 / $148.06 / $293.55	Professional	TC	$77.51	$148.06	$293.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $51.27 / $56.86	Professional	26	$34.97	$51.27	$56.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.59 / $202.45 / $327.80	Professional		$151.59	$202.45	$327.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.98 / $58.80 / $95.01	Professional	26	$49.98	$58.80	$95.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.98 / $131.02 / $240.00	Professional	TC	$101.98	$131.02	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.27 / $87.64 / $162.91	Professional		$50.27	$87.64	$162.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.61 / $318.67 / $514.98	Professional		$155.61	$318.67	$514.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.44 / $78.33 / $144.00	Professional	26	$50.44	$78.33	$144.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.56 / $223.99 / $396.85	Professional	TC	$99.56	$223.99	$396.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $166.14	Professional		$32.34	$32.34	$166.14
United Facility/Professional Professional Modifier Low / Median / High Price $146.04 / $236.60 / $333.76	Professional		$146.04	$236.60	$333.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.06 / $56.35 / $79.55	Professional	26	$48.06	$56.35	$79.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.04 / $184.44 / $261.77	Professional	TC	$97.04	$184.44	$261.77