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 / $382.75	Professional		$123.22	$221.75	$382.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.25 / $49.16 / $114.93	Professional	26	$45.25	$49.16	$114.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.51 / $147.47 / $291.63	Professional	TC	$77.51	$147.47	$291.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.99 / $54.68 / $56.86	Professional	26	$34.99	$54.68	$56.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.88 / $198.55 / $327.80	Professional		$148.88	$198.55	$327.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.97 / $58.32 / $88.90	Professional	26	$46.97	$58.32	$88.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.79 / $131.02 / $240.00	Professional	TC	$101.79	$131.02	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.11 / $87.48 / $162.53	Professional		$48.11	$87.48	$162.53
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 $155.22 / $310.95 / $509.33	Professional		$155.22	$310.95	$509.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.44 / $76.78 / $114.67	Professional	26	$50.44	$76.78	$114.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.18 / $224.43 / $395.41	Professional	TC	$99.18	$224.43	$395.41
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 $144.66 / $235.92 / $333.59	Professional		$144.66	$235.92	$333.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.13 / $55.92 / $79.53	Professional	26	$46.13	$55.92	$79.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.34 / $160.22 / $261.33	Professional	TC	$93.34	$160.22	$261.33