Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.50 / $82.50 / $111.05	Facility	26	$82.50	$82.50	$111.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.92 / $331.93 / $522.50	Professional		$257.92	$331.93	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.50 / $106.71 / $193.88	Professional	26	$82.50	$106.71	$193.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $175.43 / $230.95 / $368.50	Professional	TC	$175.43	$230.95	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.18 / $63.18 / $78.53	Professional	26	$63.18	$63.18	$78.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $287.52 / $375.25 / $574.08	Professional		$287.52	$375.25	$574.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.20 / $99.06 / $147.71	Professional	26	$84.20	$99.06	$147.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $203.33 / $267.91 / $432.85	Professional	TC	$203.33	$267.91	$432.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.67 / $126.35 / $336.98	Professional		$85.67	$126.35	$336.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.82 / $96.82 / $96.82	Facility	26	$96.82	$96.82	$96.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.75 / $601.07 / $1,107.06	Professional		$323.75	$601.07	$1,107.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.90 / $133.00 / $203.06	Professional	26	$77.90	$133.00	$203.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.50 / $477.64 / $932.93	Professional	TC	$223.50	$477.64	$932.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $377.80	Professional		$32.34	$32.34	$377.80
United Facility/Professional Professional Modifier Low / Median / High Price $290.30 / $445.58 / $678.30	Professional		$290.30	$445.58	$678.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.90 / $95.79 / $131.60	Professional	26	$77.90	$95.79	$131.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $336.16 / $574.29	Professional	TC	$194.98	$336.16	$574.29