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 $122.63 / $221.75 / $449.00	Professional		$122.63	$221.75	$449.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.63 / $50.42 / $146.44	Professional	26	$44.63	$50.42	$146.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.92 / $146.90 / $291.63	Professional	TC	$76.92	$146.90	$291.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $101.42 / $126.82	Professional		$85.81	$101.42	$126.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.99 / $51.27 / $56.86	Professional	26	$34.99	$51.27	$56.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.66 / $198.55 / $327.80	Professional		$148.66	$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 $101.09 / $131.02 / $240.00	Professional	TC	$101.09	$131.02	$240.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $87.48 / $162.13	Professional		$48.72	$87.48	$162.13
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 $154.46 / $309.77 / $507.89	Professional		$154.46	$309.77	$507.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.44 / $77.53 / $145.60	Professional	26	$50.44	$77.53	$145.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.41 / $223.28 / $393.97	Professional	TC	$98.41	$223.28	$393.97
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 $144.02 / $236.38 / $329.15	Professional		$144.02	$236.38	$329.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.38 / $56.35 / $81.20	Professional	26	$46.38	$56.35	$81.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.03 / $159.15 / $260.45	Professional	TC	$95.03	$159.15	$260.45