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 $158.22 / $274.70 / $438.99	Professional		$158.22	$274.70	$438.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.17 / $55.90 / $214.84	Professional	26	$53.17	$55.90	$214.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.72 / $198.79 / $368.85	Professional	TC	$104.72	$198.79	$368.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $48.00 / $63.64	Professional	26	$40.72	$48.00	$63.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.52 / $241.77 / $370.95	Professional		$199.52	$241.77	$370.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $64.50 / $95.01	Professional	26	$54.82	$64.50	$95.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.88 / $177.27 / $267.76	Professional	TC	$137.88	$177.27	$267.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.26 / $114.55 / $207.93	Professional		$56.26	$114.55	$207.93
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 $199.12 / $344.65 / $570.45	Professional		$199.12	$344.65	$570.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.99 / $85.99 / $132.00	Professional	26	$50.99	$85.99	$132.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.91 / $269.42 / $456.46	Professional	TC	$133.91	$269.42	$456.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $193.08	Professional		$32.34	$32.34	$193.08
United Facility/Professional Professional Modifier Low / Median / High Price $181.70 / $267.64 / $395.91	Professional		$181.70	$267.64	$395.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $60.32 / $112.45	Professional	26	$51.50	$60.32	$112.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.20 / $185.05 / $289.14	Professional	TC	$123.20	$185.05	$289.14