Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.13 / $75.69 / $105.79	Facility	26	$56.13	$75.69	$105.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.56 / $275.00 / $520.83	Professional		$160.56	$275.00	$520.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.78 / $58.69 / $136.30	Professional	26	$54.78	$58.69	$136.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.43 / $164.47 / $376.52	Professional	TC	$104.43	$164.47	$376.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.74 / $66.78 / $99.54	Professional	26	$42.74	$66.78	$99.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.53 / $251.52 / $374.85	Professional		$201.53	$251.52	$374.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.49 / $67.64 / $100.20	Professional	26	$57.49	$67.64	$100.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.97 / $190.00 / $266.64	Professional	TC	$138.97	$190.00	$266.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $117.13 / $211.44	Professional		$61.30	$117.13	$211.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.00 / $392.34 / $613.74	Professional		$202.00	$392.34	$613.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.50 / $90.20 / $138.40	Professional	26	$53.50	$90.20	$138.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.53 / $279.07 / $478.58	Professional	TC	$133.53	$279.07	$478.58
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 $173.00 / $276.17 / $400.50	Professional		$173.00	$276.17	$400.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.79 / $63.37 / $105.12	Professional	26	$52.79	$63.37	$105.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.77 / $204.62 / $322.89	Professional	TC	$122.77	$204.62	$322.89