Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $54.95 / $85.11	Facility	26	$45.71	$54.95	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $218.78 / $501.19	Professional		$128.82	$218.78	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $58.88 / $190.55	Professional	26	$43.65	$58.88	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $125.89 / $309.03	Professional	TC	$81.28	$125.89	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $97.72 / $288.40	Professional		$87.10	$97.72	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $50.12 / $87.10	Professional	26	$34.67	$50.12	$87.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $109.65	Professional	TC	$77.62	$77.62	$109.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $199.53 / $467.74	Professional		$173.78	$199.53	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $58.88 / $104.71	Professional	26	$53.70	$58.88	$104.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $125.89 / $346.74	Professional	TC	$114.82	$125.89	$346.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $83.18 / $154.88	Professional		$47.86	$83.18	$154.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $75.86	Facility	26	$11.48	$53.70	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $398.11 / $1,230.27	Professional		$173.78	$398.11	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $89.13 / $275.42	Professional	26	$46.77	$89.13	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $269.15 / $741.31	Professional	TC	$100.00	$269.15	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $245.47 / $338.84	Professional		$141.25	$245.47	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $56.23 / $89.13	Professional	26	$46.77	$56.23	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $190.55 / $269.15	Professional	TC	$95.50	$190.55	$269.15