Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.50 / $71.72 / $102.05	Facility	26	$53.50	$71.72	$102.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.89 / $275.00 / $495.42	Professional		$210.89	$275.00	$495.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.17 / $55.90 / $202.51	Professional	26	$53.17	$55.90	$202.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.38 / $217.46 / $357.09	Professional	TC	$157.38	$217.46	$357.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $176.56 / $176.56 / $176.56	Professional		$176.56	$176.56	$176.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.67 / $40.72 / $63.64	Professional	26	$40.67	$40.72	$63.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.60 / $250.79 / $370.95	Professional		$204.60	$250.79	$370.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.81 / $64.48 / $95.01	Professional	26	$54.81	$64.48	$95.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.78 / $193.04 / $267.76	Professional	TC	$149.78	$193.04	$267.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.26 / $171.95 / $280.62	Professional		$56.26	$171.95	$280.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.44 / $388.27 / $598.01	Professional		$231.44	$388.27	$598.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.72 / $82.34 / $135.75	Professional	26	$50.72	$82.34	$135.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.36 / $304.30 / $466.01	Professional	TC	$176.36	$304.30	$466.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $243.88	Professional		$32.34	$32.34	$243.88
United Facility/Professional Professional Modifier Low / Median / High Price $219.97 / $282.66 / $401.14	Professional		$219.97	$282.66	$401.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $62.03 / $96.47	Professional	26	$50.67	$62.03	$96.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.32 / $225.59 / $322.20	Professional	TC	$162.32	$225.59	$322.20