Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $60.26 / $107.15	Facility	26	$57.54	$60.26	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $251.19 / $436.52	Professional		$186.21	$251.19	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $64.57 / $117.49	Professional	26	$54.95	$64.57	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $173.78 / $323.59	Professional	TC	$128.82	$173.78	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $63.10 / $72.44	Professional	26	$44.67	$63.10	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $288.40 / $549.54	Professional		$251.19	$288.40	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $70.79 / $117.49	Professional	26	$67.61	$70.79	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $218.78 / $416.87	Professional	TC	$190.55	$218.78	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $75.86 / $91.20	Professional		$54.95	$75.86	$91.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $501.19 / $1,737.80	Professional		$245.47	$501.19	$1,737.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $109.65 / $302.00	Professional	26	$58.88	$109.65	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $407.38 / $1,148.15	Professional	TC	$158.49	$407.38	$1,148.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $245.47	Professional		$32.36	$33.11	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $354.81 / $489.78	Professional		$208.93	$354.81	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $64.57 / $109.65	Professional	26	$56.23	$64.57	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $295.12 / $407.38	Professional	TC	$151.36	$295.12	$407.38