Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.42 / $75.28 / $105.79	Facility	26	$56.42	$75.28	$105.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.44 / $275.00 / $521.41	Professional		$161.44	$275.00	$521.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.44 / $58.86 / $133.97	Professional	26	$54.44	$58.86	$133.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.02 / $165.40 / $377.54	Professional	TC	$105.02	$165.40	$377.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.97 / $67.15 / $100.16	Professional	26	$42.97	$67.15	$100.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.12 / $251.52 / $377.11	Professional		$202.12	$251.52	$377.11
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 $138.25 / $190.00 / $268.33	Professional	TC	$138.25	$190.00	$268.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $88.64 / $220.91	Professional		$61.64	$88.64	$220.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $66.34 / $66.34	Facility	26	$66.34	$66.34	$66.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.97 / $394.71 / $615.04	Professional		$202.97	$394.71	$615.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.50 / $86.34 / $138.40	Professional	26	$53.50	$86.34	$138.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.29 / $280.86 / $494.11	Professional	TC	$134.29	$280.86	$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 $184.67 / $282.42 / $404.31	Professional		$184.67	$282.42	$404.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.01 / $63.05 / $93.66	Professional	26	$54.01	$63.05	$93.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.20 / $206.25 / $305.99	Professional	TC	$123.20	$206.25	$305.99