Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.13 / $56.13 / $75.28	Facility	26	$56.13	$56.13	$75.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.81 / $248.27 / $423.46	Professional		$213.81	$248.27	$423.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $58.18 / $75.28	Professional	26	$52.46	$58.18	$75.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.68 / $172.46 / $357.10	Professional	TC	$157.68	$172.46	$357.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.28 / $43.28 / $58.76	Professional	26	$43.28	$43.28	$58.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $238.87 / $281.02 / $425.91	Professional		$238.87	$281.02	$425.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.19 / $67.29 / $98.92	Professional	26	$57.19	$67.29	$98.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $181.67 / $213.73 / $324.74	Professional	TC	$181.67	$213.73	$324.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.43 / $85.47 / $331.59	Professional		$61.43	$85.47	$331.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.48 / $453.71 / $764.34	Professional		$288.48	$453.71	$764.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.22 / $90.20 / $165.10	Professional	26	$53.22	$90.20	$165.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.24 / $348.55 / $625.94	Professional	TC	$231.24	$348.55	$625.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $272.31	Professional		$32.34	$32.34	$272.31
United Facility/Professional Professional Modifier Low / Median / High Price $247.17 / $346.70 / $488.09	Professional		$247.17	$346.70	$488.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.32 / $63.04 / $105.12	Professional	26	$54.32	$63.04	$105.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.19 / $282.68 / $407.30	Professional	TC	$186.19	$282.68	$407.30