Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.83 / $55.83 / $75.28	Facility	26	$55.83	$55.83	$75.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.81 / $246.85 / $563.50	Professional		$184.81	$246.85	$563.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $58.18 / $84.15	Professional	26	$52.78	$58.18	$84.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.97 / $176.79 / $417.34	Professional	TC	$128.97	$176.79	$417.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.95 / $50.95 / $58.45	Professional	26	$50.95	$50.95	$58.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.59 / $300.83 / $448.04	Professional		$230.59	$300.83	$448.04
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 $170.00 / $233.55 / $339.82	Professional	TC	$170.00	$233.55	$339.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.03 / $85.02 / $242.82	Professional		$61.03	$85.02	$242.82
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 $233.07 / $429.33 / $724.61	Professional		$233.07	$429.33	$724.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.50 / $85.88 / $138.40	Professional	26	$53.50	$85.88	$138.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.98 / $339.07 / $605.02	Professional	TC	$164.98	$339.07	$605.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $225.47	Professional		$32.34	$32.34	$225.47
United Facility/Professional Professional Modifier Low / Median / High Price $212.34 / $318.51 / $474.27	Professional		$212.34	$318.51	$474.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.11 / $63.37 / $105.12	Professional	26	$53.11	$63.37	$105.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.78 / $256.23 / $381.13	Professional	TC	$158.78	$256.23	$381.13