Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $79.43 / $104.71	Facility	26	$56.23	$79.43	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $446.68	Professional		$169.82	$234.42	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $67.61 / $208.93	Professional	26	$53.70	$67.61	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $158.49 / $288.40	Professional	TC	$112.20	$158.49	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$380.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $67.61 / $128.82	Professional	26	$42.66	$67.61	$128.82
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 $53.70 / $72.44 / $87.10	Professional		$53.70	$72.44	$87.10
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 $213.80 / $426.58 / $1,445.44	Professional		$213.80	$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 $181.97 / $295.12 / $416.87	Professional		$181.97	$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