Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $75.86 / $102.33	Facility	26	$56.23	$75.86	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $234.42 / $524.81	Professional		$162.18	$234.42	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $213.80	Professional	26	$54.95	$74.13	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $154.88 / $331.13	Professional	TC	$107.15	$154.88	$331.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $66.07 / $72.44	Professional	26	$54.95	$66.07	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $251.19 / $501.19	Professional		$239.88	$251.19	$501.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $67.61 / $112.20	Professional	26	$64.57	$67.61	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $177.83 / $371.54	Professional	TC	$154.88	$177.83	$371.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $85.11	Professional		$52.48	$69.18	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $66.07 / $93.33	Facility	26	$14.13	$66.07	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $426.58 / $1,445.44	Professional		$208.93	$426.58	$1,445.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $102.33 / $288.40	Professional	26	$56.23	$102.33	$288.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $323.59 / $912.01	Professional	TC	$128.82	$323.59	$912.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $199.53	Professional		$32.36	$33.11	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $295.12 / $416.87	Professional		$177.83	$295.12	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $63.10 / $104.71	Professional	26	$53.70	$63.10	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $234.42 / $323.59	Professional	TC	$123.03	$234.42	$323.59