Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.13 / $75.28 / $107.05	Facility	26	$56.13	$75.28	$107.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.26 / $252.40 / $520.83	Professional		$160.26	$252.40	$520.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $58.50 / $128.75	Professional	26	$55.00	$58.50	$128.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.13 / $164.00 / $417.01	Professional	TC	$104.13	$164.00	$417.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $43.28 / $66.78	Professional	26	$42.70	$43.28	$66.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.12 / $251.52 / $375.41	Professional		$202.12	$251.52	$375.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $67.65 / $99.55	Professional	26	$57.50	$67.65	$99.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.57 / $190.00 / $267.20	Professional	TC	$138.57	$190.00	$267.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.89 / $85.47 / $210.64	Professional		$57.89	$85.47	$210.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.61 / $392.93 / $614.39	Professional		$201.61	$392.93	$614.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.22 / $86.34 / $138.40	Professional	26	$53.22	$86.34	$138.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.13 / $279.67 / $494.11	Professional	TC	$133.13	$279.67	$494.11
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 $172.99 / $275.51 / $404.20	Professional		$172.99	$275.51	$404.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.01 / $62.64 / $93.66	Professional	26	$54.01	$62.64	$93.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.44 / $168.17 / $305.98	Professional	TC	$122.44	$168.17	$305.98